Provider Demographics
NPI:1003899642
Name:KHATRI, VIJAY P (MD)
Entity Type:Individual
Prefix:DR
First Name:VIJAY
Middle Name:P
Last Name:KHATRI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4501 X ST
Mailing Address - Street 2:UC DAVIS CANCER CENTER, SUITE 3010
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2229
Mailing Address - Country:US
Mailing Address - Phone:916-734-2172
Mailing Address - Fax:916-731-5706
Practice Address - Street 1:4501 X ST
Practice Address - Street 2:UC DAVIS CANCER CENTER, SUITE 3010
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2229
Practice Address - Country:US
Practice Address - Phone:916-734-2172
Practice Address - Fax:916-731-5706
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA684922086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA68492OtherCA MEDICAL LICENSE
CAA68492OtherCA MEDICAL LICENSE