MEDICARE: DR. RAPHAEL TOUTOUNJIAN 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
1	207R00000X	Internal Medicine Physician	A80457	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	I12842	OTHER	CA	MEDICARE UPIN

General Provider Information

NPI Number	:	1013978428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAPHAEL TOUTOUNJIAN M.D.

Provider Business Mailing Address
First Line	:	1526 N EDGEMONT ST
Second Line	:	7TH FLOOR
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-5260
Country	:	US
Telephone Number	:	323-783-6830
Fax Number	:

Provider Business Practice Location Address
First Line	:	1526 N EDGEMONT ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-5260
Country	:	US
Telephone Number	:	323-783-6830
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	09/03/2021

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