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 |
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Provider Enumeration Date | 05/23/2011 |
Last Update Date | 09/10/2024 |
Medicare PECOS PAC ID | 8426234568 |
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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 |
Inpatient Services Of California, Inc., A Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 975 S. Fairmont Ave, Lodi, CA 95240 Phone: 214-712-2400 |