Provider Demographics
NPI:1669560660
Name:PICHAJ, RAISA (MD)
Entity type:Individual
Prefix:MRS
First Name:RAISA
Middle Name:
Last Name:PICHAJ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 REDLEN AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-1133
Mailing Address - Country:US
Mailing Address - Phone:626-961-5344
Mailing Address - Fax:626-961-5344
Practice Address - Street 1:5425 N FIGUIROA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-4117
Practice Address - Country:US
Practice Address - Phone:323-258-0015
Practice Address - Fax:323-258-6470
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37542208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice