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Individual

DR. GEORGE M RAJACICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
14914 SHERMAN WAY, VAN NUYS, CA 91405-2113
(818) 787-2020
(818) 787-8652
Mailing address
14914 SHERMAN WAY, VAN NUYS, CA 91405-2113
(818) 787-2020
(818) 787-8652

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G44103
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0063310
CA
01
WG44103D
PPIN
CA
01
ZZZ91696Z
BLUE SHIELD
CA
Enumeration date
06/20/2005
Last updated
12/02/2016
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