Provider Demographics
NPI:1760631543
Name:RAY N. ISKANDER, M.D. A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:RAY N. ISKANDER, M.D. A PROFESSIONAL CORPORATION
Other - Org Name:RAEF N. ISKANDER, M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:N
Authorized Official - Last Name:ISKANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-244-5700
Mailing Address - Street 1:1505 WILSON TER
Mailing Address - Street 2:SUITE 130
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4071
Mailing Address - Country:US
Mailing Address - Phone:818-244-5700
Mailing Address - Fax:818-244-6676
Practice Address - Street 1:1505 WILSON TER
Practice Address - Street 2:SUITE 130
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4071
Practice Address - Country:US
Practice Address - Phone:818-244-5700
Practice Address - Fax:818-244-6676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A250241Medicaid
CAA24253Medicare UPIN
CAA25024Medicare PIN