Provider Demographics
NPI:1295165645
Name:RAZI MEDICAL GROUP INC
Entity type:Organization
Organization Name:RAZI MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARASH
Authorized Official - Middle Name:
Authorized Official - Last Name:MILANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-713-6969
Mailing Address - Street 1:12740 HESPERIA RD STE A
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-8306
Mailing Address - Country:US
Mailing Address - Phone:760-245-6106
Mailing Address - Fax:760-245-9448
Practice Address - Street 1:12740 HESPERIA RD STE B
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-8306
Practice Address - Country:US
Practice Address - Phone:760-713-6969
Practice Address - Fax:760-245-9448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-22
Last Update Date:2020-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA118364207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA113065Medicare UPIN