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NPI Code Detail

MEDICARE: JANAK K RAVAL MD

MEDICARE: JANAK K RAVAL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianG46723CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
200G467230OTHERCABLUE SHIELD

General Provider Information

NPI Number : 1194700393
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANAK K RAVAL MD
Provider Business Mailing Address
First Line : DEPT LA 21552
Second Line :
City : PASADENA
State : CA
Zip : 91185-1552
Country : US
Telephone Number : 949-263-8600
Fax Number : 949-263-1639
Provider Business Practice Location Address
First Line : 4101 TORRANCE BLVD
Second Line :
City : TORRANCE
State : CA
Zip : 90503-4607
Country : US
Telephone Number : 310-540-7676
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2005
Last Update Date : 04/25/2013

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