Provider Demographics
NPI:1962482919
Name:RAWAL, RACHNA (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHNA
Middle Name:
Last Name:RAWAL
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 1:12675 LA MIRADA BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-2200
Mailing Address - Country:US
Mailing Address - Phone:562-944-8054
Mailing Address - Fax:562-946-5324
Practice Address - Street 1:12675 LA MIRADA BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-2200
Practice Address - Country:US
Practice Address - Phone:562-944-8054
Practice Address - Fax:562-946-5324
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82575208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A825750Medicaid