MEDICARE: COREY RAFFEL M.D., PH.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	207T00000X	Neurological Surgery Physician	G46212	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316924707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COREY RAFFEL M.D., PH.D.

Provider Business Mailing Address
First Line	:	DEPARTMENT OF NEUROLOGICAL SURGERY M780
Second Line	:	505 PARNASSUS AVE.
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94143-0001
Country	:	US
Telephone Number	:	415-353-3489
Fax Number	:	415-353-3907

Provider Business Practice Location Address
First Line	:	DEPARTMENT OF NEUROLOGICAL SURGERY M780
Second Line	:	505 PARNASSUS AVE.
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94143-0001
Country	:	US
Telephone Number	:	415-353-3489
Fax Number	:	415-353-3907

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

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	09/16/2013

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