Provider Demographics
NPI:1639335268
Name:RAI, AANMOL INDERJEET KAUR (MD)
Entity Type:Individual
Prefix:DR
First Name:AANMOL
Middle Name:INDERJEET KAUR
Last Name:RAI
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 1:78140 CALLE TAMPICO
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-2900
Mailing Address - Country:US
Mailing Address - Phone:760-863-7970
Mailing Address - Fax:
Practice Address - Street 1:78140 CALLE TAMPICO
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-2900
Practice Address - Country:US
Practice Address - Phone:760-863-7970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4347322084P0804X
CAA1138812084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry