Provider Demographics
NPI:1326218926
Name:POLAZZI, RACHEL T (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:T
Last Name:POLAZZI
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 S AVENUE 61
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-4199
Mailing Address - Country:US
Mailing Address - Phone:323-257-1378
Mailing Address - Fax:
Practice Address - Street 1:606 S AVENUE 61
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-4199
Practice Address - Country:US
Practice Address - Phone:323-257-1378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2008-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9283112367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered