Provider Demographics
NPI:1528254133
Name:RASKIN, DAMON BRADLEY (MD)
Entity type:Individual
Prefix:DR
First Name:DAMON
Middle Name:BRADLEY
Last Name:RASKIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:881 ALMA REAL DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-3731
Mailing Address - Country:US
Mailing Address - Phone:310-459-4333
Mailing Address - Fax:310-230-1953
Practice Address - Street 1:881 ALMA REAL DR
Practice Address - Street 2:SUITE 103
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-3731
Practice Address - Country:US
Practice Address - Phone:310-459-4333
Practice Address - Fax:310-230-1953
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2015-11-02
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Provider Licenses
StateLicense IDTaxonomies
CAG81334207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG81334Medicare PIN