Individual
DR. RAJA B BOUTROS
Active
Individual
DR. RAJA B BOUTROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
A499730
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A499730
BLUE CROSS ID#
CA
05
—
0693834
—
CA
01
—
90050380
PACIFICARE ID#
CA
01
—
GR0091910
MEDICAL GROUP #
CA
Enumeration date
09/06/2006
Last updated
07/09/2007
Update your record
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