Provider Demographics
NPI:1790812683
Name:RAZI, RAFAT SHAIKH (DMD, MPH)
Entity Type:Individual
Prefix:DR
First Name:RAFAT
Middle Name:SHAIKH
Last Name:RAZI
Suffix:
Gender:F
Credentials:DMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W YOSEMITE AVE
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95336-5602
Mailing Address - Country:US
Mailing Address - Phone:209-518-3564
Mailing Address - Fax:
Practice Address - Street 1:150 W YOSEMITE AVE
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-5602
Practice Address - Country:US
Practice Address - Phone:209-825-1747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA531361223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB53136-01OtherHEALTHY FAMILIES, DELTA D
CA1725590OtherUNITED CONCORDIA