Provider Demographics
NPI:1639332703
Name:RAJ P RAJANI MD
Entity Type:Organization
Organization Name:RAJ P RAJANI MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR OF PRACTICE
Authorized Official - Prefix:
Authorized Official - First Name:RAJ
Authorized Official - Middle Name:PARSRAM
Authorized Official - Last Name:RAJANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-833-6411
Mailing Address - Street 1:PO BOX 631
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91788-0631
Mailing Address - Country:US
Mailing Address - Phone:714-833-6411
Mailing Address - Fax:503-285-3590
Practice Address - Street 1:1107 S ANAHEIM BLVD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-5811
Practice Address - Country:US
Practice Address - Phone:714-833-6411
Practice Address - Fax:503-285-3590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA425802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA85809Medicare UPIN
CAA42580Medicare PIN