Individual
MR. KEVIN WILLIAM RAUCHUT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
5901 W OLYMPIC BLVD STE 310, LOS ANGELES, CA 90036-4664
(323) 215-1725
(323) 205-3867
Mailing address
5901 W OLYMPIC BLVD STE 310, LOS ANGELES, CA 90036-4664
(323) 215-1725
(323) 205-3867
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
95006830
CA
363LG0600X
Gerontology Nurse Practitioner
95006830
CA
Other
Enumeration date
06/29/2017
Last updated
08/06/2020
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