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General NPI Number Information
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NPI Number | 1184840209
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Entity Type | Organization
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Legal Business Name | ROBERT A RACHAL
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 6040 B LAKE ISABELLA BLVD
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City | LAKE ISABELLA
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State | CA
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Zip | 93240
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Country | US
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Telephone | 760-379-5532
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2955
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City | LAKE ISABELLA
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State | CA
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Zip | 93240-2955
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Country | US
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Telephone | 760-379-5532
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Fax |
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Authorized Official
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Title or Position | PROVIDER ADMINISTRATOR
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Name | MR. ROBERT A RACHAL
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Credential | BC-HIS
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Telephone | 760-379-5532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HA0030350
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License Number State | CA
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