Provider Demographics
NPI:1760713069
Name:RIFAT B. RIFAT, M.D., INC
Entity Type:Organization
Organization Name:RIFAT B. RIFAT, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RIFAT
Authorized Official - Middle Name:B
Authorized Official - Last Name:RIFAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-895-7944
Mailing Address - Street 1:13950 MILTON AVE STE 404
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-2939
Mailing Address - Country:US
Mailing Address - Phone:714-895-7944
Mailing Address - Fax:714-731-8310
Practice Address - Street 1:13950 MILTON AVE STE 404
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-2939
Practice Address - Country:US
Practice Address - Phone:714-895-7944
Practice Address - Fax:714-731-8310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG49369207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty