Provider Demographics
NPI:1972843480
Name:SANJAY DEEPAK BHOJRAJ MD INC
Entity Type:Organization
Organization Name:SANJAY DEEPAK BHOJRAJ MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:DEEPAK
Authorized Official - Last Name:BHOJRAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-268-8865
Mailing Address - Street 1:39815 ALTA MURRIETA DR
Mailing Address - Street 2:C-1
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-5459
Mailing Address - Country:US
Mailing Address - Phone:951-268-8865
Mailing Address - Fax:951-656-1510
Practice Address - Street 1:39815 ALTA MURRIETA DR
Practice Address - Street 2:C-1
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-5459
Practice Address - Country:US
Practice Address - Phone:951-268-8865
Practice Address - Fax:951-656-1510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA112163207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA112163OtherMEDICAL LICENSE