Healthcare Provider Details

I. General information

NPI: 1619132297
Provider Name (Legal Business Name): DAVID RAWLE ZELAYA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2008
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 S ST LOUIS ST FL 1
LOS ANGELES CA
90033-4320
US

IV. Provider business mailing address

8549 WILSHIRE BLVD STE 1089
BEVERLY HILLS CA
90211-3104
US

V. Phone/Fax

Practice location:
  • Phone: 213-480-1557
  • Fax:
Mailing address:
  • Phone: 626-227-7014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95036754
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: