MEDICARE: MRS. FADIA RAFLA ATTIA MD

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	207R00000X	Internal Medicine Physician	A45954	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578626925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FADIA RAFLA ATTIA MD

Provider Business Mailing Address
First Line	:	1901 TOWN AND COUNTRY DR STE 104
Second Line	:
City	:	NORCO
State	:	CA
Zip	:	92860-3611
Country	:	US
Telephone Number	:	951-808-6240
Fax Number	:	951-738-9954

Provider Business Practice Location Address
First Line	:	1820 FULLERTON AVE STE 115
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92881-3160
Country	:	US
Telephone Number	:	951-734-3233
Fax Number	:	951-734-5284

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

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	05/12/2020

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