Provider Demographics
NPI:1154361871
Name:BERAL, RABIN (DPM)
Entity type:Individual
Prefix:DR
First Name:RABIN
Middle Name:
Last Name:BERAL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3521 LOMITA BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5041
Mailing Address - Country:US
Mailing Address - Phone:310-534-9131
Mailing Address - Fax:310-534-9132
Practice Address - Street 1:1141 W REDONDO BEACH BLVD STE 206
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-3584
Practice Address - Country:US
Practice Address - Phone:310-515-8155
Practice Address - Fax:310-515-8833
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE4528213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE4528OtherBD OF PODIATRIC MEDICINE
CA000E45280Medicaid
CA5185000001OtherDMERC
CA113721442OtherTIN
CA113721442OtherTIN
CAU98722Medicare UPIN