Healthcare Provider Details

I. General information

NPI: 1295769453
Provider Name (Legal Business Name): PATRICK RAYMOND M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 12/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 W DUARTE RD
ARCADIA CA
91007-7601
US

IV. Provider business mailing address

PO BOX 3098
TORRANCE CA
90510-3098
US

V. Phone/Fax

Practice location:
  • Phone: 626-445-4714
  • Fax:
Mailing address:
  • Phone: 310-792-3914
  • Fax: 310-792-3802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG52818
License Number StateCA

VIII. Authorized Official

Name: PATRICK A. RAYMOND
Title or Position: PRESIDENT
Credential: M.D.
Phone: 626-445-4714