Provider Demographics
NPI:1821188251
Name:SIDRAK, RAFIK M (MD)
Entity Type:Individual
Prefix:MR
First Name:RAFIK
Middle Name:M
Last Name:SIDRAK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4010 WATSON PLAZA DR
Mailing Address - Street 2:SUITE 285
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-4037
Mailing Address - Country:US
Mailing Address - Phone:562-497-1505
Mailing Address - Fax:562-497-1881
Practice Address - Street 1:4010 WATSON PLAZA DR
Practice Address - Street 2:SUITE 285
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-4037
Practice Address - Country:US
Practice Address - Phone:562-497-1505
Practice Address - Fax:562-497-1881
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2013-06-13
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Provider Licenses
StateLicense IDTaxonomies
CAA409962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry