Individual
RAUL LASTIMOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
411 SUNSET ST, ELKHART, KS 67950-5001
(620) 697-2175
(620) 697-5697
Mailing address
888 GRAND CONCOURSE, BRONX, NY 10451-2802
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0439836
KS
Other
Enumeration date
07/24/2014
Last updated
04/05/2018
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