Provider Demographics
NPI:1902885510
Name:RASSEN, JOSHUA
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:RASSEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-3612
Mailing Address - Country:US
Mailing Address - Phone:415-751-1446
Mailing Address - Fax:415-752-6312
Practice Address - Street 1:700 25TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-3612
Practice Address - Country:US
Practice Address - Phone:415-751-1446
Practice Address - Fax:415-752-6312
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG27677207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA43443Medicare UPIN