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NPI Code Detail

MEDICARE: RACHEL BARANCO M.D.

MEDICARE: RACHEL BARANCO M.D.
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
1208000000XPediatrics PhysicianA050813CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1WA50813BOTHERCAMEDI-CAL NO.

General Provider Information

NPI Number : 1578668117
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL BARANCO M.D.
Provider Business Mailing Address
First Line : 8475 S VAN NESS AVE STE 106
Second Line :
City : INGLEWOOD
State : CA
Zip : 90305-1565
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10300 COMPTON AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90002-3628
Country : US
Telephone Number : 323-564-4331
Fax Number : 323-563-1636
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2006
Last Update Date : 03/05/2015

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