Provider Demographics
NPI:1003058777
Name:TOUFAN RAZI, MEDICAL INCORPORATION
Entity Type:Organization
Organization Name:TOUFAN RAZI, MEDICAL INCORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:TOUFAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-278-2700
Mailing Address - Street 1:2410 MERCED ST
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4211
Mailing Address - Country:US
Mailing Address - Phone:510-278-2700
Mailing Address - Fax:510-278-2772
Practice Address - Street 1:2410 MERCED ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4211
Practice Address - Country:US
Practice Address - Phone:510-278-2700
Practice Address - Fax:510-278-2772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-27
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82682207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABX760AMedicare PIN