Provider Demographics
NPI:1356416978
Name:PINA, RACQUEL (MD)
Entity type:Individual
Prefix:DR
First Name:RACQUEL
Middle Name:
Last Name:PINA
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:PO BOX 9879
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93389-1879
Mailing Address - Country:US
Mailing Address - Phone:661-327-1431
Mailing Address - Fax:661-321-3286
Practice Address - Street 1:9500 STOCKDALE HWY
Practice Address - Street 2:SUITE #201
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3620
Practice Address - Country:US
Practice Address - Phone:661-327-1431
Practice Address - Fax:661-321-3286
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86596207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A865960Medicaid
CA00A865960OtherBLUE SHIELD
GAP00372136OtherMEDICARE RAILROAD
GAP00372136OtherMEDICARE RAILROAD
CA00A865960Medicaid