Jesse Earl Rathbun Jr., M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

A22086 Issued in CA

Practice address

1920 Grace Dr.
Santa Rosa, CA 95404

Phone

(707) 528-1671

NPI assigned

Oct 5, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1114492162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 GRACE DR.",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95404",
            "telephone_number": "707-528-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 GRACE DR.",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95404",
            "telephone_number": "707-528-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHBUN",
        "first_name": "JESSE",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-05",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A22086",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A22086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert William Rappaport
• Rashidi Medical Corporation
• Mahmoud Rashidi-Naimabadi, MD
• Alicia Louise Rasmussen
• Jennifer V Ratcliffe, M.D., PH.D
• Kelly Alexis Rathmann, LCSW
• Brittany Leigh Ratiani, LMFT
• Lauren M Ratiani, FNP-BC
• Mondhipa Ratnarathorn, MD
• Jane Rattanavilay

• Ophthalmology Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.