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General NPI Number Information
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NPI Number | 1750275079
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Entity Type | Organization
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Legal Business Name | RACHEL PRIMARY AND SPECIALTY CARE CLINIC
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 3939 N STOCKTON HILL RD STE A
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City | KINGMAN
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State | AZ
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Zip | 86409-3247
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Country | US
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Telephone | 661-425-0295
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 16297
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City | BEVERLY HILLS
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State | CA
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Zip | 90209-2297
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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 | PRESIDENT
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Name | ROBERTO SANTANA
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Credential |
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Telephone | 661-425-0295
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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 |
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License Number State |
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