=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720410582
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DUSTIN RABER M D INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/04/2013
-----------------------------------------------------
Last Update Date | 08/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 870 W 7TH ST
-----------------------------------------------------
City | HANFORD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93230-4926
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-772-4145
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 870 W 7TH ST
-----------------------------------------------------
City | HANFORD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93230-4926
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-639-7602
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DR. DUSTIN A RABER
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 559-639-7602
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | A94854
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------