1215038674 NPI number — DR. JOHN MARK RASHKIS MD

Table of content: DR. JOHN MARK RASHKIS MD (NPI 1215038674)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215038674 NPI number — DR. JOHN MARK RASHKIS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RASHKIS
Provider First Name:
JOHN
Provider Middle Name:
MARK
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FIVECOAT
Provider Other First Name:
DONNA
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
OFFICE MANAGER
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1215038674
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/19/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
485 MONTEREY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS GATOS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95030
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-354-9200
Provider Business Mailing Address Fax Number:
408-395-5487

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
485 MONTEREY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS GATOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-354-9200
Provider Business Practice Location Address Fax Number:
408-395-5487
Provider Enumeration Date:
09/26/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  A307080 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)