Provider Demographics
NPI:1265698492
Name:RAFLA, HALA GAMAL (MPAS)
Entity type:Individual
Prefix:
First Name:HALA
Middle Name:GAMAL
Last Name:RAFLA
Suffix:
Gender:F
Credentials:MPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6140 W CURTISIAN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-0109
Mailing Address - Country:US
Mailing Address - Phone:208-367-4224
Mailing Address - Fax:208-367-7806
Practice Address - Street 1:3340 E GOLDSTONE WAY
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-1026
Practice Address - Country:US
Practice Address - Phone:208-367-5170
Practice Address - Fax:208-367-5180
Is Sole Proprietor?:No
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDPAT-513363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical