Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | G70773 | CA |
NPI | 1013065994 |
---|---|
Provider Name | Hesham T. Ragab |
First Address | Los Angeles, CA 90034-1702 |
Second Address | Los Angeles, CA 90034-1702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 30/11/2021 |