Provider Demographics
NPI:1417950957
Name:CORDEIRO, RANJIT ALEXIUS (MD)
Entity Type:Individual
Prefix:DR
First Name:RANJIT
Middle Name:ALEXIUS
Last Name:CORDEIRO
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 1:1012 W BEVERLY BLVD # 1001
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-4139
Mailing Address - Country:US
Mailing Address - Phone:323-838-5434
Mailing Address - Fax:323-838-9131
Practice Address - Street 1:110 N 4TH AVE
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1825
Practice Address - Country:US
Practice Address - Phone:626-966-3499
Practice Address - Fax:626-966-3433
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-28
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54871207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A548710Medicaid
CA00A548710Medicaid
CAW15518Medicare ID - Type Unspecified