Provider Demographics
NPI:1215991302
Name:PRESS, RAYMOND I (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:I
Last Name:PRESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 WASHINGTON STREET
Mailing Address - Street 2:#508
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2231
Mailing Address - Country:US
Mailing Address - Phone:619-299-2570
Mailing Address - Fax:619-819-7258
Practice Address - Street 1:501 WASHINGTON ST
Practice Address - Street 2:#508
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2231
Practice Address - Country:US
Practice Address - Phone:619-299-2570
Practice Address - Fax:619-819-7258
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG59304207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G593041Medicaid
CA00G593041Medicaid