Healthcare Provider Details

I. General information

NPI: 1740594415
Provider Name (Legal Business Name): RAFIK MAGDY REZK ABDOU M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2010
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11333 SEPULVEDA BLVD
MISSION HILLS CA
91345-1116
US

IV. Provider business mailing address

15031 RINALDI ST
MISSION HILLS CA
91345-1207
US

V. Phone/Fax

Practice location:
  • Phone: 818-869-7254
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA122692
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA122692
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: