Raeesy Md Inc | |
9900 Balboa Blvd Suite A Northridge CA 91325-5403 | |
(818) 701-0017 | |
(818) 701-0073 |
Full Name | Raeesy Md Inc |
---|---|
Speciality | Internal Medicine |
Location | 9900 Balboa Blvd, Northridge, California |
Authorized Official Name and Position | Amir Homayon Raeesy (OWNER) |
Authorized Official Contact | 8187010073 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Raeesy Md Inc 9900 Balboa Blvd Suite A Northridge CA 91325-5403 Ph: (818) 701-0017 | Raeesy Md Inc 9900 Balboa Blvd Suite A Northridge CA 91325-5403 Ph: (818) 701-0017 |
NPI Number | 1366731762 |
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Provider Enumeration Date | 04/06/2011 |
Last Update Date | 04/06/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366731762 | NPI | - | NPPES |
A97308 | Other | CA | MEDICAL LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | A97308 (California) | Primary |
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