Provider Demographics
NPI:1275781205
Name:SALMAN S RAZI MD INC
Entity Type:Organization
Organization Name:SALMAN S RAZI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF UROLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:SALMAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-833-3449
Mailing Address - Street 1:2160 W GRANT LINE RD
Mailing Address - Street 2:140
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-7330
Mailing Address - Country:US
Mailing Address - Phone:209-833-3449
Mailing Address - Fax:209-833-8786
Practice Address - Street 1:1144 NORMAN DR
Practice Address - Street 2:204
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-5925
Practice Address - Country:US
Practice Address - Phone:209-833-3449
Practice Address - Fax:209-833-8786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55879208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A558790Medicare PIN