Provider Demographics
NPI:1881919090
Name:RAJNEESH, KIRAN F (MBBS, MS)
Entity type:Individual
Prefix:DR
First Name:KIRAN
Middle Name:F
Last Name:RAJNEESH
Suffix:
Gender:M
Credentials:MBBS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 BLOSSOM ST STE D
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4237
Mailing Address - Country:US
Mailing Address - Phone:949-872-8829
Mailing Address - Fax:
Practice Address - Street 1:560 BLOSSOM ST STE D
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4237
Practice Address - Country:US
Practice Address - Phone:949-872-8829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH351262172084N0400X, 2084P2900X
TXT95892084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0150365Medicaid
OHH267620Medicare PIN