Provider Demographics
NPI:1679506315
Name:WASEF, RASHAD (MD)
Entity Type:Individual
Prefix:
First Name:RASHAD
Middle Name:
Last Name:WASEF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 S RAYMOND AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-7144
Mailing Address - Country:US
Mailing Address - Phone:626-570-6016
Mailing Address - Fax:626-570-0537
Practice Address - Street 1:25 S RAYMOND AVE STE 202
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-7144
Practice Address - Country:US
Practice Address - Phone:626-570-6016
Practice Address - Fax:626-570-0537
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32546207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA26840Medicare UPIN