Provider Demographics
NPI:1023528627
Name:RAJAN, RESHMI
Entity type:Individual
Prefix:
First Name:RESHMI
Middle Name:
Last Name:RAJAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19571 CARAWAY PL
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-9239
Mailing Address - Country:US
Mailing Address - Phone:408-866-5567
Mailing Address - Fax:
Practice Address - Street 1:163 E HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-0234
Practice Address - Country:US
Practice Address - Phone:408-866-5567
Practice Address - Fax:408-866-5567
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293817208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA293817OtherPHYSICAL THERAPIST LICENSE