Healthcare Provider Details

I. General information

NPI: 1447553276
Provider Name (Legal Business Name): FRANCOISE RAIOLA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2010
Last Update Date: 05/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12665 GARDEN GROVE BLVD STE 713
GARDEN GROVE CA
92843-1921
US

IV. Provider business mailing address

12665 GARDEN GROVE BLVD STE 713
GARDEN GROVE CA
92843-1921
US

V. Phone/Fax

Practice location:
  • Phone: 714-537-7500
  • Fax: 714-537-2176
Mailing address:
  • Phone: 714-537-7500
  • Fax: 714-537-2176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA114773
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberA114773
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: