Provider Demographics
NPI:1740431246
Name:MAHESHWARI, RAJESH KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJESH
Middle Name:KUMAR
Last Name:MAHESHWARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9140 ALCOSTA BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-3858
Mailing Address - Country:US
Mailing Address - Phone:925-361-5959
Mailing Address - Fax:925-999-0375
Practice Address - Street 1:9140 ALCOSTA BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-3858
Practice Address - Country:US
Practice Address - Phone:925-361-5959
Practice Address - Fax:925-999-0375
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA109707207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA109707OtherLICENSE