Provider Demographics
NPI:1447699822
Name:ABBASI, RAFAY (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAY
Middle Name:
Last Name:ABBASI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8010 WILLOW GLEN RD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-1617
Mailing Address - Country:US
Mailing Address - Phone:732-501-5497
Mailing Address - Fax:
Practice Address - Street 1:8010 WILLOW GLEN RD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-1617
Practice Address - Country:US
Practice Address - Phone:732-501-5497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036142136207R00000X, 208M00000X
CAA163388207R00000X
PAMT204180390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14011034OtherCAQH
ILFA6725800OtherDEA