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General NPI Number Information
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NPI Number | 1508530890
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Entity Type | Individual
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Provider Name | DR. NATALEE CAMILLE RACKUS
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Gender | Female
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 477 E COLORADO BLVD
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City | PASADENA
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State | CA
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Zip | 91101-2024
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Country | US
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Telephone | 626-796-1191
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Fax |
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Provider Business Mailing Address
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Address Line | 477 E COLORADO BLVD
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City | PASADENA
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State | CA
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Zip | 91101-2024
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT.007096
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG003831
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 36120
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License Number State | CA
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