Provider Demographics
NPI:1851497713
Name:NACH, RAPHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAPHAEL
Middle Name:
Last Name:NACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8631 W 3RD ST
Mailing Address - Street 2:STE 945E
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5912
Mailing Address - Country:US
Mailing Address - Phone:310-858-4493
Mailing Address - Fax:310-858-4497
Practice Address - Street 1:435 NORTH ROXBURY DRIVE
Practice Address - Street 2:#207
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210
Practice Address - Country:US
Practice Address - Phone:310-858-4493
Practice Address - Fax:310-858-4497
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA31162207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA31162Medicare ID - Type Unspecified
A26376Medicare UPIN