| Rajeev Shukla Md | |
|
999 S Fairmont Ave Suite 135 Lodi CA 95240-5100 | |
| (209) 366-2031 | |
| (209) 366-2032 |
| Full Name | Rajeev Shukla Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 999 S Fairmont Ave, Lodi, California |
| Authorized Official Name and Position | Rajeev Shukla (OWNER) |
| Authorized Official Contact | 2097127017 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rajeev Shukla Md 845 S Fairmont Ave Ste 135 Lodi CA 95240-3971 Ph: (209) 224-5385 | Rajeev Shukla Md 999 S Fairmont Ave Suite 135 Lodi CA 95240-5100 Ph: (209) 366-2031 |
| NPI Number | 1851684930 |
|---|---|
| Provider Enumeration Date | 05/23/2011 |
| Last Update Date | 09/10/2024 |
| Medicare PECOS PAC ID | 8426234568 |
|---|---|
| Medicare Enrollment ID | O20110525000430 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851684930 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A51690 (California) | Primary |
| Provider Name | Rajeev Shukla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548289630 PECOS PAC ID: 7911061718 Enrollment ID: I20090122000459 |
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