Provider Demographics
NPI:1245422559
Name:BASRAON, RAJVIR KAUR (MD)
Entity type:Individual
Prefix:
First Name:RAJVIR
Middle Name:KAUR
Last Name:BASRAON
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 1:1180 E SHAW AVE
Mailing Address - Street 2:SUIT 101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7812
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1180 E SHAW AVE
Practice Address - Street 2:SUIT 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7812
Practice Address - Country:US
Practice Address - Phone:559-228-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA122530208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist