Provider Demographics
NPI:1124124920
Name:MIZRAHI, RABIN (MD)
Entity type:Individual
Prefix:DR
First Name:RABIN
Middle Name:
Last Name:MIZRAHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7218 VAN NUYS BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-6804
Mailing Address - Country:US
Mailing Address - Phone:818-997-7575
Mailing Address - Fax:818-997-7577
Practice Address - Street 1:7218 VAN NUYS BLVD STE D
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-6804
Practice Address - Country:US
Practice Address - Phone:818-997-7575
Practice Address - Fax:818-997-7577
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68667174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG93557Medicare UPIN
CAWA68667AMedicare ID - Type Unspecified