MEDICARE: DR. ASIF WAQAR RAFI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207K00000X	Allergy & Immunology Physician	A78785	CA

General Provider Information

NPI Number	:	1265549455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASIF WAQAR RAFI M.D.

Provider Business Mailing Address
First Line	:	11500 WEST OLYMPIC BLVD
Second Line	:	SUITE 630
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1538
Country	:	US
Telephone Number	:	310-393-1550
Fax Number	:	310-478-3601

Provider Business Practice Location Address
First Line	:	11500 WEST OLYMPIC BLVD
Second Line	:	SUITE 630
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1538
Country	:	US
Telephone Number	:	310-393-1550
Fax Number	:	310-478-3601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	01/05/2011

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