MEDICARE: DR. FRANK ELIAS RAFAIL D.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	1223G0001X	General Practice Dentistry	37483	CA

General Provider Information

NPI Number	:	1730195520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK ELIAS RAFAIL D.M.D.

Provider Business Mailing Address
First Line	:	11738 CARNEL MOUNTAIN ROAD
Second Line	:	STE 170
City	:	SAN DIEGO
State	:	CA
Zip	:	92128
Country	:	US
Telephone Number	:	858-675-1180
Fax Number	:	858-675-0663

Provider Business Practice Location Address
First Line	:	11738 CARMEL MOUNTAIN RD
Second Line	:	STE 170
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-4634
Country	:	US
Telephone Number	:	858-675-1180
Fax Number	:	858-675-0663

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	07/08/2007

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