Provider Demographics
NPI:1225607112
Name:MCCLATCHEY, RACHEL L (PA-C)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:L
Last Name:MCCLATCHEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:GULA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1441 EASTLAKE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90089-1019
Mailing Address - Country:US
Mailing Address - Phone:323-865-3950
Mailing Address - Fax:323-865-0060
Practice Address - Street 1:1441 EASTLAKE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-4740
Practice Address - Country:US
Practice Address - Phone:323-865-3950
Practice Address - Fax:323-865-0060
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-23
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPA2021-0106363A00000X, 363AS0400X
CAPA64889363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical