Basic Information
Provider Information
NPI: 1245334648
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAZOOKI
FirstName: GEORGE
MiddleName: ZIA
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2140 PASEO GRANDE
Address2:  
City: EL CAJON
State: CA
PostalCode: 920193853
CountryCode: US
TelephoneNumber: 6195791194
FaxNumber:  
Practice Location
Address1: 8810 RIO SAN DIEGO DR
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921081622
CountryCode: US
TelephoneNumber: 6194005000
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/07/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XA51424CAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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