Healthcare Provider Details

I. General information

NPI: 1871501205
Provider Name (Legal Business Name): RAZI D HEKMAT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 EUCLID AVE STE 202
NATIONAL CITY CA
91950-2952
US

IV. Provider business mailing address

610 EUCLID AVE STE 202
NATIONAL CITY CA
91950-2952
US

V. Phone/Fax

Practice location:
  • Phone: 619-472-2665
  • Fax: 619-479-9468
Mailing address:
  • Phone: 619-472-2665
  • Fax: 619-479-9468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA75886
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: