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General NPI Number Information
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NPI Number | 1063787232
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Entity Type | Organization
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Legal Business Name | RAFAEL REISFELD M.D. A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 03/20/2012
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 1125 S BEVERLY DR SUTIE 500
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City | LOS ANGELES
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State | CA
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Zip | 90035-1148
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Country | US
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Telephone | 310-557-3037
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Fax | 310-557-3554
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Provider Business Mailing Address
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Address Line | 1125 S BEVERLY DR SUTIE 500
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City | LOS ANGELES
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State | CA
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Zip | 90035-1148
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Country | US
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Telephone | 310-557-3037
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Fax | 310-557-3554
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Authorized Official
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Title or Position | GENERAL SURGEON
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Name | DR. RAFAEL REISFELD
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Credential | M.D.
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Telephone | 310-557-3037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A32774
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License Number State | CA
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