Basic Information
| Provider Information | |||||||||
| NPI: | 1356416978 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PINA | ||||||||
| FirstName: | RACQUEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9879 | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933891879 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613271431 | ||||||||
| FaxNumber: | 6613213286 | ||||||||
| Practice Location | |||||||||
| Address1: | 9500 STOCKDALE HWY | ||||||||
| Address2: | SUITE #201 | ||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933113620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613271431 | ||||||||
| FaxNumber: | 6613213286 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2006 | ||||||||
| LastUpdateDate: | 12/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A86596 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00A865960 | 05 | CA | MEDICAID | 00A865960 | 01 | CA | BLUE SHIELD | OTHER | P00372136 | 01 | GA | MEDICARE RAILROAD | OTHER |