Provider Demographics
NPI:1770657470
Name:DESHMUKH, ANJALI RAJIV (MD)
Entity Type:Individual
Prefix:DR
First Name:ANJALI
Middle Name:RAJIV
Last Name:DESHMUKH
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 1:2001 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2741
Mailing Address - Country:US
Mailing Address - Phone:408-261-7135
Mailing Address - Fax:408-554-9960
Practice Address - Street 1:2001 THE ALAMEDA
Practice Address - Street 2:SERVICE TEAM A OUTPATIENT ALAMEDA
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2741
Practice Address - Country:US
Practice Address - Phone:408-261-7135
Practice Address - Fax:408-554-9960
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA492432084P0800X, 2084P0804X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Not Answered2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A492430OtherPPIN
00A492430OtherPPIN
ZZZ01125ZMedicare ID - Type Unspecified