Provider Demographics
NPI:1033328828
Name:DR. RACHEL WEST, INC.
Entity Type:Organization
Organization Name:DR. RACHEL WEST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:310-450-8959
Mailing Address - Street 1:2211 CORINTH AVE
Mailing Address - Street 2:STE 204
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1650
Mailing Address - Country:US
Mailing Address - Phone:310-450-8959
Mailing Address - Fax:310-450-8342
Practice Address - Street 1:2211 CORINTH AVE
Practice Address - Street 2:STE 204
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1650
Practice Address - Country:US
Practice Address - Phone:310-450-8959
Practice Address - Fax:310-450-8342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8690207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFJ395AMedicare UPIN