Provider Demographics
NPI:1063663466
Name:ARIAS, RAQUEL D (MD)
Entity Type:Individual
Prefix:DR
First Name:RAQUEL
Middle Name:D
Last Name:ARIAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 ZONAL AVE # KAM100-F
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90089-5648
Mailing Address - Country:US
Mailing Address - Phone:323-442-2554
Mailing Address - Fax:
Practice Address - Street 1:1975 ZONAL AVE # KAM100-F
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-5648
Practice Address - Country:US
Practice Address - Phone:323-442-2554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG50608207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology