Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | A89191 | CA |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | A89191 | CA |
NPI | 1063464089 |
---|---|
Provider Name | Bilal Rafic Kaaki |
First Address | Corona, CA 92879-1379 |
Second Address | Riverside, CA 92506-3804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 11/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
719260690 | (02) | IA |
I51243 | (02) | IA |