Provider Demographics
NPI:1265549455
Name:RAFI, ASIF WAQAR (MD)
Entity type:Individual
Prefix:DR
First Name:ASIF
Middle Name:WAQAR
Last Name:RAFI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11500 WEST OLYMPIC BLVD
Mailing Address - Street 2:SUITE 630
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1538
Mailing Address - Country:US
Mailing Address - Phone:310-393-1550
Mailing Address - Fax:310-478-3601
Practice Address - Street 1:11500 WEST OLYMPIC BLVD
Practice Address - Street 2:SUITE 630
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1538
Practice Address - Country:US
Practice Address - Phone:310-393-1550
Practice Address - Fax:310-478-3601
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA78785207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA78785CMedicare PIN
CAH33018Medicare UPIN