Provider Demographics
NPI:1164437935
Name:NADARAJAH, SENTHILRAJ (MD)
Entity Type:Individual
Prefix:
First Name:SENTHILRAJ
Middle Name:
Last Name:NADARAJAH
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 1:12855 MOORSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-7277
Mailing Address - Country:US
Mailing Address - Phone:253-232-7810
Mailing Address - Fax:
Practice Address - Street 1:12855 MOORSHIRE DR
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-7277
Practice Address - Country:US
Practice Address - Phone:253-232-7810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00040699207R00000X, 208M00000X
CACA53084207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA53084OtherCALIFORNIA