MEDICARE: DR. RAQUEL FRANCO ENRIQUEZ 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
1	207V00000X	Obstetrics & Gynecology Physician	A80615	CA

General Provider Information

NPI Number	:	1831181395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAQUEL FRANCO ENRIQUEZ M.D.

Provider Business Mailing Address
First Line	:	5119 POMONA BLVD
Second Line	:	MODULE 1
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-1711
Country	:	US
Telephone Number	:	800-954-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	5119 POMONA BLVD
Second Line	:	MODULE 1
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-1711
Country	:	US
Telephone Number	:	800-954-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	12/16/2021

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