Provider Demographics
NPI:1407958234
Name:ISKANDER, RAAFAT (MD)
Entity Type:Individual
Prefix:
First Name:RAAFAT
Middle Name:
Last Name:ISKANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 1708
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5801
Mailing Address - Country:US
Mailing Address - Phone:323-939-0008
Mailing Address - Fax:323-939-0070
Practice Address - Street 1:6200 WILSHIRE BLVD
Practice Address - Street 2:SUITE 1708
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5801
Practice Address - Country:US
Practice Address - Phone:323-939-0008
Practice Address - Fax:323-939-0070
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA836042084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1407958234Medicaid
CAW17808Medicaid
CA00A546420OtherBLUE SHIELD
CA00A836040Medicaid
CA200159043OtherBLUE CROSS PROVIDER