Provider Demographics
NPI:1962413625
Name:RABER, DUSTIN A (MD)
Entity type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:A
Last Name:RABER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 906
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93232-0906
Mailing Address - Country:US
Mailing Address - Phone:559-587-4115
Mailing Address - Fax:559-587-4189
Practice Address - Street 1:1524 W LACEY BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5965
Practice Address - Country:US
Practice Address - Phone:559-583-4507
Practice Address - Fax:559-583-4686
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94854207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA94854OtherMEDICAL LICENSE
CAA94854OtherMEDICAL LICENSE
00A948541Medicare PIN