Provider Demographics
NPI:1598850083
Name:RAI, BALDEV S (MD)
Entity Type:Individual
Prefix:DR
First Name:BALDEV
Middle Name:S
Last Name:RAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4234 RIVERWALK PKWY 280
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3370
Mailing Address - Country:US
Mailing Address - Phone:951-784-7190
Mailing Address - Fax:951-784-7246
Practice Address - Street 1:4234 RIVERWALK PKWY
Practice Address - Street 2:SUITE 280
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-8510
Practice Address - Country:US
Practice Address - Phone:951-785-7190
Practice Address - Fax:951-688-7246
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA417092084S0012X, 2084N0400X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA41709OtherCA LICENSE
CAA41709OtherCA LICENSE
CAA29439Medicare UPIN