Organization
SAINT MARY PED NEUROG MED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAAFAT ISKANDER MD (MEDICAL DIRECTOR)
(323) 939-0008
Entity
Organization
Contact information
Practice address
6200 WILSHIRE BLVD SUITE 1708, LOS ANGELES, CA 90048-5818
(323) 939-0008
Mailing address
6200 WILSHIRE BLVD SUITE 1708, LOS ANGELES, CA 90048-5818
(323) 939-0008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A836040
CA
207T00000X
Neurological Surgery Physician
Primary
A836041
CA
Other
Enumeration date
04/10/2008
Last updated
04/10/2008
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