Healthcare Provider Details

I. General information

NPI: 1396991014
Provider Name (Legal Business Name): RIFFAT MERAJ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2008
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 W LA PALMA AVE STE 709
ANAHEIM CA
92801-2814
US

IV. Provider business mailing address

1211 W LA PALMA AVE STE 709
ANAHEIM CA
92801-2814
US

V. Phone/Fax

Practice location:
  • Phone: 714-772-8282
  • Fax: 714-577-2125
Mailing address:
  • Phone: 714-577-2124
  • Fax: 714-577-2125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberD0073803
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: