Provider Demographics
NPI:1447408224
Name:RAJAN, PREET (MMS,PA-C)
Entity Type:Individual
Prefix:MRS
First Name:PREET
Middle Name:
Last Name:RAJAN
Suffix:
Gender:F
Credentials:MMS,PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3071 PAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-4054
Mailing Address - Country:US
Mailing Address - Phone:408-540-5400
Mailing Address - Fax:
Practice Address - Street 1:3071 PAYNE AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4054
Practice Address - Country:US
Practice Address - Phone:408-540-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19337363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant