Provider Demographics
NPI:1922201003
Name:NIRAULA, RAJENDRA P (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJENDRA
Middle Name:P
Last Name:NIRAULA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 W GONZALES RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-3072
Mailing Address - Country:US
Mailing Address - Phone:805-278-9094
Mailing Address - Fax:805-278-8918
Practice Address - Street 1:1200 W GONZALES RD
Practice Address - Street 2:SUITE 300
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-3072
Practice Address - Country:US
Practice Address - Phone:805-278-9094
Practice Address - Fax:805-278-8918
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35089409207R00000X
CAA106860207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ75566ZMedicaid
CA110039977OtherMEDICARE RAILROAD
CAZZZ34679ZOtherBLUE CROSS
CACJ250ZMedicare PIN