Provider Demographics
NPI:1952463564
Name:ISKANDER, RAIF WADIE (PA-C, DC)
Entity Type:Individual
Prefix:DR
First Name:RAIF
Middle Name:WADIE
Last Name:ISKANDER
Suffix:
Gender:M
Credentials:PA-C, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1431 WARNER AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6444
Mailing Address - Country:US
Mailing Address - Phone:949-734-4335
Mailing Address - Fax:949-264-1083
Practice Address - Street 1:1431 WARNER AVE
Practice Address - Street 2:SUITE D
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6444
Practice Address - Country:US
Practice Address - Phone:949-734-4335
Practice Address - Fax:949-264-1083
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23282111N00000X
CAPA21793363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No111N00000XChiropractic ProvidersChiropractor