Provider Demographics
NPI:1508086802
Name:RAO, KAJAL D (MD)
Entity Type:Individual
Prefix:DR
First Name:KAJAL
Middle Name:D
Last Name:RAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:KAJAL
Other - Middle Name:A
Other - Last Name:DESAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9695 S YOSEMITE ST
Mailing Address - Street 2:SUITE 285
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-2888
Mailing Address - Country:US
Mailing Address - Phone:303-799-8760
Mailing Address - Fax:303-799-8767
Practice Address - Street 1:130 RAMPART WAY
Practice Address - Street 2:SUITE 300B
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-6440
Practice Address - Country:US
Practice Address - Phone:303-327-4700
Practice Address - Fax:303-327-4711
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA228605207R00000X
CAA107569207RN0300X
IL036130940207RN0300X
CO54045207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO28677382Medicaid
CO370576YVBJOtherMEDICARE PTAN