| Raj Prasad Md Inc | |
|
8711 Venice Blvd Los Angeles CA 90034-3216 | |
| (310) 237-0023 | |
| (310) 237-0026 |
| Full Name | Raj Prasad Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8711 Venice Blvd, Los Angeles, California |
| Authorized Official Name and Position | Rajendra Prasad (OWNER) |
| Authorized Official Contact | 3102370023 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Raj Prasad Md Inc 8711 Venice Blvd Los Angeles CA 90034-3216 Ph: (310) 237-0023 | Raj Prasad Md Inc 8711 Venice Blvd Los Angeles CA 90034-3216 Ph: (310) 237-0023 |
| NPI Number | 1962563080 |
|---|---|
| Provider Enumeration Date | 12/12/2006 |
| Last Update Date | 02/01/2022 |
| Medicare PECOS PAC ID | 7810067378 |
|---|---|
| Medicare Enrollment ID | O20080610000496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962563080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A68598 (California) | Primary |
| Provider Name | Rajendra Prasad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427119536 PECOS PAC ID: 8426968264 Enrollment ID: I20040131000056 |
| Provider Name | Ajmal Mohammad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700017712 PECOS PAC ID: 2365570504 Enrollment ID: I20100510000669 |
| Provider Name | Josh Kwan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285145995 PECOS PAC ID: 0941569776 Enrollment ID: I20180124000105 |
| Provider Name | Johnpaul Singh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982087847 PECOS PAC ID: 8325396195 Enrollment ID: I20210824002739 |
| Provider Name | Shelly Prasad Chawla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447664636 PECOS PAC ID: 8628347523 Enrollment ID: I20211013002451 |
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