Provider Demographics
NPI:1730286402
Name:RAYHRER, CONSTANZE S (MD)
Entity Type:Individual
Prefix:DR
First Name:CONSTANZE
Middle Name:S
Last Name:RAYHRER
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 1:2605 LOMA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-1548
Mailing Address - Country:US
Mailing Address - Phone:805-648-2227
Mailing Address - Fax:805-648-6706
Practice Address - Street 1:2605 LOMA VISTA RD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1548
Practice Address - Country:US
Practice Address - Phone:805-648-2227
Practice Address - Fax:805-648-6706
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG84660208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G846600Medicaid
CAG84660OtherSTATE LICENSE
WG84660BMedicare PIN
CAG74564Medicare UPIN