Basic Information
Provider Information
NPI: 1033129614
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VELEK
FirstName: RACHEL
MiddleName: FERN
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SMITH
OtherFirstName: RACHEL
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 1411 EAST 31ST ST
Address2: OAKCARE MEDICAL GROUP
City: OAKLAND
State: CA
PostalCode: 94602
CountryCode: US
TelephoneNumber: 5104374323
FaxNumber: 5104375042
Practice Location
Address1: 1411 EAST 31ST ST
Address2: OAKCARE MEDICAL GROUP
City: OAKLAND
State: CA
PostalCode: 94602
CountryCode: US
TelephoneNumber: 5104374323
FaxNumber: 5104375042
Other Information
ProviderEnumerationDate: 08/08/2006
LastUpdateDate: 02/22/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XA74670CAY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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