Individual
MR. ALI REZA RAFATJOO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
360 SAN MIGUEL DR, SUITE 206, NEWPORT BEACH, CA 92660-7853
(949) 640-4455
(949) 640-4456
Mailing address
360 SAN MIGUEL DR, SUITE 206, NEWPORT BEACH, CA 92660-7853
(949) 640-4455
(949) 640-4456
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A54980
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A054980
MEDICAL LICENSE
CA
Enumeration date
07/21/2006
Last updated
03/02/2021
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