Provider Demographics
NPI:1356756712
Name:M. RAJUDIN, M.D., INC.
Entity type:Organization
Organization Name:M. RAJUDIN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:M.
Authorized Official - Middle Name:MASH-HOORDIN
Authorized Official - Last Name:RAJUDIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-229-9500
Mailing Address - Street 1:3010 W ORANGE AVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3169
Mailing Address - Country:US
Mailing Address - Phone:714-229-9500
Mailing Address - Fax:714-229-9904
Practice Address - Street 1:3055 W ORANGE AVE STE 204
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3154
Practice Address - Country:US
Practice Address - Phone:714-229-9500
Practice Address - Fax:714-229-9904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-24
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA26154207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty