Provider Demographics
NPI:1740693878
Name:DHANJEE, BHAVEER K
Entity type:Individual
Prefix:
First Name:BHAVEER
Middle Name:K
Last Name:DHANJEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2135 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:ESCALON
Mailing Address - State:CA
Mailing Address - Zip Code:95320-2051
Mailing Address - Country:US
Mailing Address - Phone:209-581-3431
Mailing Address - Fax:209-838-6855
Practice Address - Street 1:2135 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:ESCALON
Practice Address - State:CA
Practice Address - Zip Code:95320-2051
Practice Address - Country:US
Practice Address - Phone:209-581-3431
Practice Address - Fax:209-838-6855
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA666852183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist