Provider Demographics
NPI:1982714887
Name:EL-HARAZI, SHERIF MOSTAFA (MD MPH)
Entity type:Individual
Prefix:
First Name:SHERIF
Middle Name:MOSTAFA
Last Name:EL-HARAZI
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 S CENTRAL AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-2569
Mailing Address - Country:US
Mailing Address - Phone:818-265-2255
Mailing Address - Fax:818-507-5027
Practice Address - Street 1:1510 S CENTRAL AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2569
Practice Address - Country:US
Practice Address - Phone:818-265-2255
Practice Address - Fax:818-507-5027
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74584207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A745840Medicaid
GA180046451OtherRAILROAD MEDICARE
CAH44306Medicare UPIN
CAWA74584AMedicare PIN
CAA74584Medicare UPIN