Provider Demographics
NPI:1407535578
Name:REFAEL HEALTHCARE PA
Entity Type:Organization
Organization Name:REFAEL HEALTHCARE PA
Other - Org Name:REFAEL HEALTHCARE P.A.
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-879-7167
Mailing Address - Street 1:8200 WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2328
Mailing Address - Country:US
Mailing Address - Phone:310-879-7167
Mailing Address - Fax:
Practice Address - Street 1:5850 SAN FELIPE ST STE 500
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-8003
Practice Address - Country:US
Practice Address - Phone:310-879-7167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-14
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty