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Organization
SHARO S RAISSI MD PC
Active
Organization
SHARO S RAISSI MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHARO S RAISSI M.D. (PRESIDENT)
(310) 291-2166
Entity
Organization
Contact information
Practice address
6310 SAN VICENTE BLVD, STE 220, LOS ANGELES, CA 90048-5426
(310) 291-2166
(800) 756-8714
Mailing address
16750 VIA PACIFICA, PACIFIC PALISADES, CA 90272-1949
(310) 291-2166
(714) 829-3011
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A44386
CA
Other
Enumeration date
12/10/2012
Last updated
12/11/2012
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