Individual
RAISA HEIFETS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6027 YORK BLVD, LOS ANGELES, CA 90042-3503
(323) 256-1556
(323) 256-1836
Mailing address
6027 YORK BLVD, LOS ANGELES, CA 90042-3503
(323) 256-1556
(323) 256-1836
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A40429
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A404290
—
CA
Enumeration date
10/12/2006
Last updated
07/08/2007
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