Provider Demographics
NPI:1386271682
Name:AL-RABADI, DINA
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:
Last Name:AL-RABADI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 WILSHIRE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-1422
Mailing Address - Country:US
Mailing Address - Phone:818-423-4442
Mailing Address - Fax:
Practice Address - Street 1:530 WILSHIRE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-1422
Practice Address - Country:US
Practice Address - Phone:818-423-4442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-25
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A20813207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty