Provider Demographics
NPI:1164638870
Name:GHOSHEH, RAJAI KAMEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJAI
Middle Name:KAMEL
Last Name:GHOSHEH
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 1:27451 LOS ALTOS
Mailing Address - Street 2:SUITE 290
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6331
Mailing Address - Country:US
Mailing Address - Phone:949-582-5008
Mailing Address - Fax:
Practice Address - Street 1:27451 LOS ALTOS
Practice Address - Street 2:SUITE 290
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6331
Practice Address - Country:US
Practice Address - Phone:949-582-5008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA420332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry