Provider Demographics
NPI:1558471540
Name:PRASAD, RAJESH (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJESH
Middle Name:
Last Name:PRASAD
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 1:18550 DE PAUL DRIVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037
Mailing Address - Country:US
Mailing Address - Phone:408-778-7248
Mailing Address - Fax:408-778-7227
Practice Address - Street 1:18550 DE PAUL DRIVE
Practice Address - Street 2:SUITE 107
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95020
Practice Address - Country:US
Practice Address - Phone:408-778-7248
Practice Address - Fax:408-778-7227
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50724207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A507241Medicaid
CA00A507241Medicaid
CAA507240Medicare PIN
CA00A507240Medicare PIN