MEDICARE: DAMON B. RASKIN MD INC

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	G081334	CA

General Provider Information

NPI Number	:	1164483061
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAMON B. RASKIN MD INC

Provider Business Mailing Address
First Line	:	881 ALMA REAL DR
Second Line	:
City	:	PACIFIC PALISADES
State	:	CA
Zip	:	90272-3740
Country	:	US
Telephone Number	:	310-459-4333
Fax Number	:	310-454-4707

Provider Business Practice Location Address
First Line	:	881 ALMA REAL DR
Second Line	:	SUITE 103
City	:	PACIFIC PALISADES
State	:	CA
Zip	:	90272-3731
Country	:	US
Telephone Number	:	310-459-4333
Fax Number	:	310-454-4707

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAMON RASKIN
Credential	:	MD
Telephone Number	:	310-459-4333

Provider Enumeration Date	:	03/30/2006
Last Update Date	:	08/22/2020

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