Provider Demographics
NPI:1861503278
Name:RAINS, VICTORIA SHAW (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:SHAW
Last Name:RAINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:30524 LOS ALTOS DR
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-7424
Mailing Address - Country:US
Mailing Address - Phone:909-335-3759
Mailing Address - Fax:909-389-9494
Practice Address - Street 1:30524 LOS ALTOS DR
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-7424
Practice Address - Country:US
Practice Address - Phone:909-335-3759
Practice Address - Fax:909-389-9494
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG50812207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G508121Medicaid
CAE86994Medicare UPIN
CA00G508120Medicare ID - Type Unspecified