Provider Demographics
NPI:1346310539
Name:RAPPAPORT, ALLAN H (MD, JD)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:H
Last Name:RAPPAPORT
Suffix:
Gender:M
Credentials:MD, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 156
Mailing Address - Street 2:
Mailing Address - City:TIBURON
Mailing Address - State:CA
Mailing Address - Zip Code:94920-0156
Mailing Address - Country:US
Mailing Address - Phone:415-435-4591
Mailing Address - Fax:415-435-2930
Practice Address - Street 1:39 MAIN ST
Practice Address - Street 2:
Practice Address - City:TIBURON
Practice Address - State:CA
Practice Address - Zip Code:94920-2507
Practice Address - Country:US
Practice Address - Phone:415-435-4591
Practice Address - Fax:415-435-4591
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACR51892085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000Medicare UPIN