Provider Demographics
NPI:1891006375
Name:HUEZO, RAFAEL (MD)
Entity Type:Individual
Prefix:
First Name:RAFAEL
Middle Name:
Last Name:HUEZO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8787 HALL RD
Mailing Address - Street 2:
Mailing Address - City:LAMONT
Mailing Address - State:CA
Mailing Address - Zip Code:93241-1953
Mailing Address - Country:US
Mailing Address - Phone:661-845-3731
Mailing Address - Fax:661-845-1157
Practice Address - Street 1:1430 TRUXTUN AVE STE 400
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5220
Practice Address - Country:US
Practice Address - Phone:661-635-3050
Practice Address - Fax:661-869-1503
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA121288207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine