Healthcare Provider Details

I. General information

NPI: 1770160376
Provider Name (Legal Business Name): EKRA RAI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2021
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 WESTWOOD PLZ
LOS ANGELES CA
90095-8358
US

IV. Provider business mailing address

14650 AVIATION BLVD STE 100
HAWTHORNE CA
90250-6667
US

V. Phone/Fax

Practice location:
  • Phone: 310-267-9124
  • Fax:
Mailing address:
  • Phone: 855-522-3682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberA192648
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: