Provider Demographics
NPI:1659594570
Name:SHERIF M EL-HARAZI MD INC
Entity Type:Organization
Organization Name:SHERIF M EL-HARAZI MD INC
Other - Org Name:LUGENE EYE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERIF
Authorized Official - Middle Name:M
Authorized Official - Last Name:EL-HARAZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH
Authorized Official - Phone:818-265-2255
Mailing Address - Street 1:1510 S CENTRAL AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-2500
Mailing Address - Country:US
Mailing Address - Phone:818-265-2255
Mailing Address - Fax:818-507-5027
Practice Address - Street 1:1510 S CENTRAL AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2569
Practice Address - Country:US
Practice Address - Phone:818-265-2255
Practice Address - Fax:818-507-5027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207W00000X
CAA74584207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GADF4513OtherRAILROAD MEDICARE
CAGR0101250Medicaid
GADF4513OtherRAILROAD MEDICARE