Provider Demographics
NPI:1841215803
Name:ISRAEL, RAFI (MD)
Entity Type:Individual
Prefix:DR
First Name:RAFI
Middle Name:
Last Name:ISRAEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RAFI
Other - Middle Name:
Other - Last Name:ESRAIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9025 WILSHIRE BLVD
Mailing Address - Street 2:#209
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211
Mailing Address - Country:US
Mailing Address - Phone:310-276-3450
Mailing Address - Fax:310-276-3548
Practice Address - Street 1:9025 WILSHIRE BLVD
Practice Address - Street 2:#209
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211
Practice Address - Country:US
Practice Address - Phone:310-651-2300
Practice Address - Fax:310-651-2342
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72843207ND0101X, 207R00000X, 207W00000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA72843Medicare ID - Type Unspecified
CAG96821Medicare UPIN