Dhiraj Raj Jeyanandarajan | |
11121 Sun Center Dr Suite G Rancho Cordova CA 95670-6161 | |
(916) 631-0112 | |
(916) 631-1652 |
Full Name | Dhiraj Raj Jeyanandarajan |
---|---|
Speciality | Psychiatry & Neurology |
Location | 11121 Sun Center Dr, Rancho Cordova, California |
Authorized Official Name and Position | Dhiraj Raj Jeyanandarajan (PRESIDENT) |
Authorized Official Contact | 9166310112 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Dhiraj Raj Jeyanandarajan 11121 Sun Center Dr Suite G Rancho Cordova CA 95670-6161 Ph: (916) 631-0112 | Dhiraj Raj Jeyanandarajan 11121 Sun Center Dr Suite G Rancho Cordova CA 95670-6161 Ph: (916) 631-0112 |
NPI Number | 1790083723 |
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Provider Enumeration Date | 02/28/2011 |
Last Update Date | 02/28/2011 |
Medicare PECOS PAC ID | 0042493066 |
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Medicare Enrollment ID | O20110328000835 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790083723 | NPI | - | NPPES |
1154547719 | Other | CA | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | A91259 (California) | Primary |
Provider Name | Dhiraj Raj Jeyanandarajan |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1154547719 PECOS PAC ID: 4486716388 Enrollment ID: I20110328000870 |
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