Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | G34720 | CA |
NPI | 1013941962 |
---|---|
Provider Name | Bernard Raskin |
First Address | Valencia, CA 91355-5092 |
Second Address | Valencia, CA 91355 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 18/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G347200 | (05) | CA |
1013941962 | NPI (01) | CA |
A46045 | (02) |