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NPI Code Detail

MEDICARE: MARINA RAIKHEL M D A MEDICAL CORPORATION

MEDICARE: MARINA RAIKHEL M D A MEDICAL CORPORATION
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
1207Q00000XFamily Medicine PhysicianA49056CA

General Provider Information

NPI Number : 1497739734
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARINA RAIKHEL M D A MEDICAL CORPORATION
Provider Business Mailing Address
First Line : 25043 NARBONNE AVE
Second Line :
City : LOMITA
State : CA
Zip : 90717-2101
Country : US
Telephone Number : 310-373-8120
Fax Number : 424-203-8980
Provider Business Practice Location Address
First Line : 25043 NARBONNE AVE
Second Line :
City : LOMITA
State : CA
Zip : 90717-2101
Country : US
Telephone Number : 310-373-8120
Fax Number : 424-203-8980
Authorized Official
Title or Position : DIRECTOR
Name : DR. MARINA RAIKHEL
Credential : MD
Telephone Number : 310-373-8120
Provider Enumeration Date : 11/30/2005
Last Update Date : 12/29/2009

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