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Individual

LAITH TAWFEEQ ALRESHAID

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1000 S FREMONT AVE BLDG A9, OFFICE OF REVENUE CYCLE MANAGEMENT PROVIDER ENROLLMEN, ALHAMBRA, CA 91803-8800
(626) 457-5848
(626) 457-4125
Mailing address
4499 VIA MARISOL, APT 139, LOS ANGELES, CA 90042-5147
(626) 437-1991

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301103709
MI
207P00000X
Emergency Medicine Physician
Primary
A144334
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1730529694
MEDICARE
CA
Enumeration date
06/25/2013
Last updated
08/22/2016
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