Basic Information
| Provider Information | |||||||||
| NPI: | 1184637605 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAUSCH | ||||||||
| FirstName: | HOLLY | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1240 S WESTLAKE BLVD | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | WESTLAKE VILLAGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913611929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8054950551 | ||||||||
| FaxNumber: | 8054968079 | ||||||||
| Practice Location | |||||||||
| Address1: | 1240 S WESTLAKE BLVD | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | WESTLAKE VILLAGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913611929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8054950551 | ||||||||
| FaxNumber: | 8054968079 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2006 | ||||||||
| LastUpdateDate: | 08/31/2010 | ||||||||
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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 | 207N00000X | A95019 | CA | Y | Allopathic & Osteopathic Physicians | Dermatology | 207ND0900X | A95019 | CA | N | Allopathic & Osteopathic Physicians | Dermatology | Dermatopathology |
ID Information
| ID | Type | State | Issuer | Description | 1184637605 | 01 | CA | NPI | OTHER |