Provider Demographics
NPI:1255577904
Name:RAINOW, ALEX (MD)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:
Last Name:RAINOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BON AIR RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1144
Mailing Address - Country:US
Mailing Address - Phone:415-927-0666
Mailing Address - Fax:415-927-6159
Practice Address - Street 1:651 1ST ST W STE L
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-7046
Practice Address - Country:US
Practice Address - Phone:707-935-1470
Practice Address - Fax:707-935-7817
Is Sole Proprietor?:No
Enumeration Date:2008-12-31
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC154306207RC0000X
FLME116443207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHM293ZMedicare PIN