Provider Demographics
NPI:1235433855
Name:ASHOK K RAHEJA M.D.
Entity Type:Organization
Organization Name:ASHOK K RAHEJA M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:K
Authorized Official - Last Name:RAHEJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-638-9977
Mailing Address - Street 1:3621, MARTIN LUTHER KING JR. BLVD.
Mailing Address - Street 2:#10
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-3512
Mailing Address - Country:US
Mailing Address - Phone:310-638-9977
Mailing Address - Fax:310-638-8615
Practice Address - Street 1:3621 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:#10
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-3512
Practice Address - Country:US
Practice Address - Phone:310-638-9977
Practice Address - Fax:310-638-8615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-23
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA36879207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A368790Medicaid
CAA36879Medicare PIN
CA00A368790Medicaid