Provider Demographics
NPI:1831271378
Name:BARAJAS, RAYMOND ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:ANTHONY
Last Name:BARAJAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8518 VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-4362
Mailing Address - Country:US
Mailing Address - Phone:626-571-5969
Mailing Address - Fax:
Practice Address - Street 1:3560 SANTA ANITA AVE
Practice Address - Street 2:STE H
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731
Practice Address - Country:US
Practice Address - Phone:626-579-9595
Practice Address - Fax:626-579-3851
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75499207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G754990Medicaid