Provider Demographics
NPI:1568995868
Name:RAZA, MEHER FATIMA (DO)
Entity Type:Individual
Prefix:
First Name:MEHER
Middle Name:FATIMA
Last Name:RAZA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MEHER
Other - Middle Name:FATIMA
Other - Last Name:RAZA-ESTES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:2110 E EL SEGUNDO BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-2743
Mailing Address - Country:US
Mailing Address - Phone:310-784-8745
Mailing Address - Fax:310-893-0431
Practice Address - Street 1:2110 E EL SEGUNDO BLVD STE 220
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-2743
Practice Address - Country:US
Practice Address - Phone:310-784-8745
Practice Address - Fax:310-893-0431
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA20A20074207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program