Provider Demographics
NPI:1568656817
Name:RAFFAELE M. CORBISIERO M.D. INC
Entity Type:Organization
Organization Name:RAFFAELE M. CORBISIERO M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFFAELE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CORBISIERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-914-5051
Mailing Address - Street 1:210 S GRAND AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-4268
Mailing Address - Country:US
Mailing Address - Phone:626-914-5051
Mailing Address - Fax:626-914-5068
Practice Address - Street 1:210 S GRAND AVE STE 207
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-4268
Practice Address - Country:US
Practice Address - Phone:626-914-5051
Practice Address - Fax:626-914-5068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty