Healthcare Provider Details

I. General information

NPI: 1154499655
Provider Name (Legal Business Name): RACHNA KUCHERIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 05/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1091 S LA BREA AVE
INGLEWOOD CA
90301
US

IV. Provider business mailing address

23430 HAWTHORNE BLVD BLDG. 3, SUITE 210
TORRANCE CA
90505-4720
US

V. Phone/Fax

Practice location:
  • Phone: 310-330-2960
  • Fax: 310-330-2961
Mailing address:
  • Phone: 310-802-6177
  • Fax: 310-802-6178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA79833
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: