Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | A112425 | CA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | A112425 | CA |
NPI | 1215084009 |
---|---|
Provider Name | Rachel Triche |
First Address | Santa Monica, CA 90404-2139 |
Second Address | Santa Monica, CA 90404-2139 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 24/08/2012 |