Provider Demographics
NPI:1982366738
Name:RAZZAK, SAQIB ABDUL (OD)
Entity Type:Individual
Prefix:DR
First Name:SAQIB
Middle Name:ABDUL
Last Name:RAZZAK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13031 DESTINO LN
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-8606
Mailing Address - Country:US
Mailing Address - Phone:562-879-4354
Mailing Address - Fax:
Practice Address - Street 1:13031 DESTINO LN
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-8606
Practice Address - Country:US
Practice Address - Phone:562-879-4354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35027152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist