Provider Demographics
NPI:1023058476
Name:GRANDHE, JANARDHAN RAO (MD)
Entity type:Individual
Prefix:DR
First Name:JANARDHAN
Middle Name:RAO
Last Name:GRANDHE
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 1:2012 NORWICH WAY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-2910
Mailing Address - Country:US
Mailing Address - Phone:661-333-4042
Mailing Address - Fax:
Practice Address - Street 1:5339 TRUXTUN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0641
Practice Address - Country:US
Practice Address - Phone:661-327-9300
Practice Address - Fax:661-327-9301
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52798207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A527980Medicaid
CA00A527980Medicare PIN
CA00A527980Medicaid