Healthcare Provider Details

I. General information

NPI: 1609102433
Provider Name (Legal Business Name): RAFAEL LEMUS-RANGEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2009
Last Update Date: 08/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1658 W AVENUE J
LANCASTER CA
93534-2814
US

IV. Provider business mailing address

25050 AVENUE KEARNY SUITE 208
VALENCIA CA
91355-1257
US

V. Phone/Fax

Practice location:
  • Phone: 661-942-8855
  • Fax: 972-616-5118
Mailing address:
  • Phone: 661-430-0940
  • Fax: 661-295-0862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA107205
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: