Provider Demographics
NPI:1669861431
Name:SOHI, RAJKAMAL
Entity type:Individual
Prefix:
First Name:RAJKAMAL
Middle Name:
Last Name:SOHI
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 1:4053 E MORADA LN
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-1608
Mailing Address - Country:US
Mailing Address - Phone:209-478-6000
Mailing Address - Fax:
Practice Address - Street 1:4053 E MORADA LN
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95212-1608
Practice Address - Country:US
Practice Address - Phone:209-478-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-17
Last Update Date:2015-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64159122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist