Provider Demographics
NPI:1558445965
Name:RALLS, JULIE ROBIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ROBIN
Last Name:RALLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2011 WESTCLIFF DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5599
Mailing Address - Country:US
Mailing Address - Phone:949-646-3316
Mailing Address - Fax:949-646-1310
Practice Address - Street 1:2011 WESTCLIFF DR
Practice Address - Street 2:SUITE 4
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-5599
Practice Address - Country:US
Practice Address - Phone:949-646-3316
Practice Address - Fax:949-646-1310
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G637001Medicaid
CA00G637001Medicaid
CA00G63700Medicare ID - Type Unspecified