Provider Demographics
NPI:1326112483
Name:RAGAB, DINA T (MD)
Entity Type:Individual
Prefix:DR
First Name:DINA
Middle Name:T
Last Name:RAGAB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3400 LOMITA BLVD
Mailing Address - Street 2:101
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4933
Mailing Address - Country:US
Mailing Address - Phone:310-539-4660
Mailing Address - Fax:310-539-3759
Practice Address - Street 1:3400 LOMITA BLVD
Practice Address - Street 2:101
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4933
Practice Address - Country:US
Practice Address - Phone:310-539-4660
Practice Address - Fax:310-539-3759
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG82060207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G820600Medicaid
G82060Medicare ID - Type Unspecified
CA00G820600Medicaid