Active NPI
Rafael Reisfeld
- Surgery Physician
- Los Angeles, CA
National Provider Identifier
1861576290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 0636480
- Practice address
- 1125 S Beverly Drive
#500
Los Angeles, CA 90035 - Phone
- (310) 557-3037
- Fax
- (310) 557-3554
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 0636480 | CA | Primary |
Addresses
Primary practice location
1125 S Beverly Drive
#500
Los Angeles, CA 90035
Mailing address
1125 S Beverly Drive
#500
Los Angeles, CA 90035
Phone (310) 557-3037
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A32774 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0636480 | CA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325635200000",
"number": "1861576290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1125 S BEVERLY DRIVE",
"address_2": "#500",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90035",
"telephone_number": "310-557-3037",
"fax_number": "310-557-3554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 S BEVERLY DRIVE",
"address_2": "#500",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90035",
"telephone_number": "310-557-3037",
"fax_number": "310-557-3554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REISFELD",
"first_name": "RAFAEL",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2012-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "0636480",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A32774",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.