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Organization
SAINT MARY PEDIATRIC NEUROLOGY MEDICAL CLINIC, INC
Active
Organization
SAINT MARY PEDIATRIC NEUROLOGY MEDICAL CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAAFAT ISKANDER M.D. (OWNER)
(323) 939-0008
Entity
Organization
Contact information
Practice address
6200 WILSHIRE BLVD, SUITE 1708, LOS ANGELES, CA 90048-5801
(323) 939-0008
(323) 939-0070
Mailing address
6200 WILSHIRE BLVD, SUITE 1708, LOS ANGELES, CA 90048-5801
(323) 939-0008
(323) 939-0070
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A83604
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A836040
—
CA
Enumeration date
10/24/2006
Last updated
08/22/2020
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