1699935080 NPI number — DR. YUL RAPOPORT DO

Table of content: DR. YUL RAPOPORT DO (NPI 1699935080)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699935080 NPI number — DR. YUL RAPOPORT DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAPOPORT
Provider First Name:
YUL
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699935080
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/03/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9735 WILSHIRE BLVD STE 308
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEVERLY HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90212-2105
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-860-0500
Provider Business Mailing Address Fax Number:
310-317-7188

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
32123 LINDERO CANYON RD STE 210
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTLAKE VILLAGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91361-5461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-877-7000
Provider Business Practice Location Address Fax Number:
818-877-7001
Provider Enumeration Date:
06/10/2008

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: 2084N0400X , with the licence number:  255853 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 109285000 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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