Basic Information
| Provider Information | |||||||||
| NPI: | 1215991302 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PRESS | ||||||||
| FirstName: | RAYMOND | ||||||||
| MiddleName: | I | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 WASHINGTON STREET | ||||||||
| Address2: | #508 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921032231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192992570 | ||||||||
| FaxNumber: | 6198197258 | ||||||||
| Practice Location | |||||||||
| Address1: | 501 WASHINGTON ST | ||||||||
| Address2: | #508 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921032231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192992570 | ||||||||
| FaxNumber: | 6198197258 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2006 | ||||||||
| LastUpdateDate: | 02/22/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | G59304 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | 00G593041 | 05 | CA | MEDICAID |