Healthcare Provider Details

I. General information

NPI: 1053498303
Provider Name (Legal Business Name): RAUL BARRERA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6336 PASSONS BLVD
PICO RIVERA CA
90660-3355
US

IV. Provider business mailing address

1225 HIATT ST
LA HABRA HEIGHTS CA
90631-8352
US

V. Phone/Fax

Practice location:
  • Phone: 888-499-9303
  • Fax:
Mailing address:
  • Phone: 323-803-8231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA73702
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: