Rafael Convalescent Hospital

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

RAFAEL CONVALESCENT HOSPITAL

Practice address

234 N San Pedro Rd
San Rafael, CA 94903-2858

Phone

(415) 479-3450

Fax

(415) 472-3723

NPI assigned

Jan 10, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Timothy Egan

Title

Administrator

Phone

(415) 479-3450

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124178645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 N SAN PEDRO RD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032858",
            "telephone_number": "415-479-3450",
            "fax_number": "415-472-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 N SAN PEDRO RD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032858",
            "telephone_number": "415-479-3450",
            "fax_number": "415-472-3723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAFAEL CONVALESCENT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EGAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "415-479-3450",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR05310F4",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allan Quijano Quiton
• Monet C Rabb-Smith
• Rachel Von Doepp CD, Cle
• Parmis Yeganeh Rad, M.D.
• Martha Radetsky, MFT
• Sahm Behnam Rafati
• Kaethlyn O Ragasa
• Analisa E Ragusa, PT, DPT
• Rasheeda Alana Rahab
• Latifa Lorena Rainbow, D.C.

• Skilled Nursing Facility in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.