Individual
RITA KACHRU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1245 16TH ST, SUITE 303, SANTA MONICA, CA 90404-1235
(310) 481-4646
(310) 899-7599
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
Primary
A77959
CA
207R00000X
Internal Medicine Physician
A77959
CA
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
A77959
CA
208000000X
Pediatrics Physician
A77959
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A77959
LICENSE
CA
01
—
ZZZ73295Z
BLUE SHIELD
CA
Enumeration date
08/15/2006
Last updated
01/02/2020
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