Provider Demographics
NPI:1992893986
Name:DANIEL M. RAYBIN, M.D.
Entity type:Organization
Organization Name:DANIEL M. RAYBIN, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAYBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-668-1835
Mailing Address - Street 1:1 SHRADER ST
Mailing Address - Street 2:SUITE 578
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1016
Mailing Address - Country:US
Mailing Address - Phone:415-668-1835
Mailing Address - Fax:415-668-8248
Practice Address - Street 1:1 SHRADER ST
Practice Address - Street 2:SUITE 578
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1016
Practice Address - Country:US
Practice Address - Phone:415-668-1835
Practice Address - Fax:415-668-8248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG30516207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ27618ZMedicare ID - Type Unspecified