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NPI Code Detail

MEDICARE: MR. RAOUL ALEXIS III

MEDICARE: MR. RAOUL ALEXIS III
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
1225400000XRehabilitation PractitionerCA

General Provider Information

NPI Number : 1417018086
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RAOUL ALEXIS III
Provider Business Mailing Address
First Line : 39 DARLINGTON PL
Second Line :
City : VALLEJO
State : CA
Zip : 94591-4300
Country : US
Telephone Number : 707-558-1600
Fax Number : 707-558-1606
Provider Business Practice Location Address
First Line : 1625 FILBERT ST
Second Line :
City : OAKLAND
State : CA
Zip : 94607-2890
Country : US
Telephone Number : 707-342-2595
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2006
Last Update Date : 09/17/2025

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