Provider Demographics
NPI:1417141300
Name:ALAN RASHKIN, M.D. A PROFESSIONAL CORP
Entity type:Organization
Organization Name:ALAN RASHKIN, M.D. A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-527-3222
Mailing Address - Street 1:1350 E LOS ANGELES AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-7839
Mailing Address - Country:US
Mailing Address - Phone:805-572-3222
Mailing Address - Fax:805-582-2651
Practice Address - Street 1:1350 E LOS ANGELES AVE STE 203
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-7839
Practice Address - Country:US
Practice Address - Phone:805-527-3222
Practice Address - Fax:805-582-2651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2019-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG38481204C00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G384810Medicaid
CAA47495Medicare UPIN
CAG38481Medicare PIN