Provider Demographics
NPI:1902959000
Name:PACHECO, RAECHEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAECHEL
Middle Name:
Last Name:PACHECO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-729 LAUNAHELE ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-4756
Mailing Address - Country:US
Mailing Address - Phone:808-554-7990
Mailing Address - Fax:808-278-5659
Practice Address - Street 1:91-1227 ENTERPRISE AVE
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2150
Practice Address - Country:US
Practice Address - Phone:080-672-1678
Practice Address - Fax:808-278-5659
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2009-0763207Q00000X
NMRS2006-0356207Q00000X
HIMD-17605207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine