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General NPI Number Information
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NPI Number | 1154350338
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Entity Type | Organization
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Legal Business Name | RABER MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17781 BEACH BLVD
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-6833
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Country | US
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Telephone | 714-596-1137
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Fax | 714-596-5989
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Provider Business Mailing Address
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Address Line | 17781 BEACH BLVD
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-6833
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Country | US
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Telephone | 714-596-1137
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Fax | 714-596-5989
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARGIE GRANT
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Credential |
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Telephone | 714-596-1137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C32134
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License Number State | CA
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