Provider Demographics
NPI:1174724660
Name:RAINBOW, LATIFA LORENA (DC)
Entity type:Individual
Prefix:DR
First Name:LATIFA
Middle Name:LORENA
Last Name:RAINBOW
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 LOCHNESS LN
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-2425
Mailing Address - Country:US
Mailing Address - Phone:415-457-9394
Mailing Address - Fax:415-457-0958
Practice Address - Street 1:12 LOCHNESS LN
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-2425
Practice Address - Country:US
Practice Address - Phone:415-457-9394
Practice Address - Fax:415-457-0958
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15019111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor