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NPI Code Detail

MEDICARE: DR. SVETLANA RAICHEL-STIVI M.D.

MEDICARE:  DR. SVETLANA  RAICHEL-STIVI  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
1207Q00000XFamily Medicine PhysicianA062626CA

General Provider Information

NPI Number : 1679508675
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SVETLANA RAICHEL-STIVI M.D.
Provider Business Mailing Address
First Line : 4699 JAMBOREE RD
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-2526
Country : US
Telephone Number : 949-557-0714
Fax Number :
Provider Business Practice Location Address
First Line : 4699 JAMBOREE RD
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-2526
Country : US
Telephone Number : 949-557-0714
Fax Number : 949-557-0715
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 12/04/2024

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Directions to “ DR. SVETLANA RAICHEL-STIVI M.D.” Practice Location

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