Provider Demographics
NPI:1730529694
Name:ALRESHAID, LAITH TAWFEEQ (MD)
Entity type:Individual
Prefix:
First Name:LAITH
Middle Name:TAWFEEQ
Last Name:ALRESHAID
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4499 VIA MARISOL
Mailing Address - Street 2:APT 139
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-5147
Mailing Address - Country:US
Mailing Address - Phone:626-437-1991
Mailing Address - Fax:
Practice Address - Street 1:1000 S FREMONT AVE BLDG A9
Practice Address - Street 2:OFFICE OF REVENUE CYCLE MANAGEMENT PROVIDER ENROLLMEN
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-8800
Practice Address - Country:US
Practice Address - Phone:626-457-5848
Practice Address - Fax:626-457-4125
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2016-08-22
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Provider Licenses
StateLicense IDTaxonomies
MI4301103709207P00000X
CAA144334207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1730529694OtherMEDICARE