Provider Demographics
NPI:1255738613
Name:DR RACHEL MAYORGA MD PC
Entity type:Organization
Organization Name:DR RACHEL MAYORGA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYORGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-755-0095
Mailing Address - Street 1:421 MARCH AVE STE D
Mailing Address - Street 2:
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-3367
Mailing Address - Country:US
Mailing Address - Phone:707-385-0222
Mailing Address - Fax:
Practice Address - Street 1:421 MARCH AVE STE D
Practice Address - Street 2:
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-3367
Practice Address - Country:US
Practice Address - Phone:707-385-0222
Practice Address - Fax:707-629-4849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care