Basic Information
Provider Information
NPI: 1023472115
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARLIN
FirstName: RACHEL
MiddleName: ELIZABETH
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4140 W 190TH ST
Address2:  
City: TORRANCE
State: CA
PostalCode: 905045513
CountryCode: US
TelephoneNumber: 3109671780
FaxNumber: 8669914287
Practice Location
Address1: 127 S SAN VICENTE BLVD STE A6600
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900483311
CountryCode: US
TelephoneNumber: 3104236472
FaxNumber: 3104230148
Other Information
ProviderEnumerationDate: 04/05/2016
LastUpdateDate: 09/28/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/28/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X54864AZN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
2084N0400X66726MNN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
2084N0400XA171438CAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
207R00000X54864AZN Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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