Provider Demographics
NPI:1134164858
Name:RABINOVITCH, ALBERT (MD)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:
Last Name:RABINOVITCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 CUERNAVACA CIRCULO
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-3577
Mailing Address - Country:US
Mailing Address - Phone:650-964-4124
Mailing Address - Fax:
Practice Address - Street 1:1220 CUERNAVACA CIRCULO
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-3577
Practice Address - Country:US
Practice Address - Phone:650-964-4124
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG85981207ZP0102X
NY209351-1207ZP0102X
OH35-03-9883-R207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA80296Medicare UPIN