Individual
MARTIN W RAUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1516 COTNER AVE, LOS ANGELES, CA 90025-3303
(310) 445-2800
(310) 445-2983
Mailing address
PO BOX 240086, LOS ANGELES, CA 90024-9186
(310) 445-2800
(310) 445-2983
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G74148
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G741480
BLUE SHIELD
CA
05
—
00G741480
—
CA
Enumeration date
06/08/2006
Last updated
11/22/2021
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