Provider Demographics
NPI:1336311760
Name:SAHOTA, RAJDEEP K (DPM)
Entity Type:Individual
Prefix:DR
First Name:RAJDEEP
Middle Name:K
Last Name:SAHOTA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 E ORANGEBURG AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-3370
Mailing Address - Country:US
Mailing Address - Phone:209-577-1411
Mailing Address - Fax:
Practice Address - Street 1:2116 E ORANGEBURG AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-3370
Practice Address - Country:US
Practice Address - Phone:209-577-1411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005852213ES0103X
CA4882213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery