Provider Demographics
NPI:1083721849
Name:KAVIRAJAN, HARISH (MD)
Entity Type:Individual
Prefix:
First Name:HARISH
Middle Name:
Last Name:KAVIRAJAN
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 1:6 VENTURE
Mailing Address - Street 2:STE 277
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3340
Mailing Address - Country:US
Mailing Address - Phone:949-422-6814
Mailing Address - Fax:949-223-4792
Practice Address - Street 1:6 VENTURE STE 277
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-7304
Practice Address - Country:US
Practice Address - Phone:949-422-6814
Practice Address - Fax:949-223-4792
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA554852084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A554850Medicaid
CAWA55485CMedicare PIN
CAA55485Medicare ID - Type UnspecifiedMEDICARE
CAG69025Medicare UPIN