Provider Demographics
NPI:1154499655
Name:KUCHERIA, RACHNA (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHNA
Middle Name:
Last Name:KUCHERIA
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 1:23430 HAWTHORNE BLVD
Mailing Address - Street 2:BLDG. 3, SUITE 210
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4720
Mailing Address - Country:US
Mailing Address - Phone:310-802-6177
Mailing Address - Fax:310-802-6178
Practice Address - Street 1:1091 S LA BREA AVE
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301
Practice Address - Country:US
Practice Address - Phone:310-330-2960
Practice Address - Fax:310-330-2961
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79833207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC70843FMedicaid
CAEAP70236FOtherEAPC
CAFHC70093FMedicaid
CAFHC71046FMedicaid
CAHAP70843FOtherFAMPACT
CAA79833OtherLICENSE NUMBER
CAHAP70093FOtherFAMPACT
CAHAP71046FOtherFAMPACT
CAFHC70843FMedicaid