Provider Demographics
NPI:1629380464
Name:MAHARAJ, JAISRI TOMARA (MD)
Entity Type:Individual
Prefix:
First Name:JAISRI
Middle Name:TOMARA
Last Name:MAHARAJ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2637 SHADELANDS DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2512
Mailing Address - Country:US
Mailing Address - Phone:925-951-0710
Mailing Address - Fax:925-951-0812
Practice Address - Street 1:2637 SHADELANDS DR
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2512
Practice Address - Country:US
Practice Address - Phone:925-951-0710
Practice Address - Fax:925-951-0812
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV26642207RE0101X
UT8631834-1205207RE0101X
CA122381207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism