Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A82681 | CA |
N | 111NI0900X | Internist | A82681 | CA |
Y | 207RN0300X | Nephrologist | A82681 | CA |
NPI | 1003836602 |
---|---|
Provider Name | Anjay Rastogi |
First Address | Los Angeles, CA 90045-5632 |
Second Address | Los Angeles, CA 90095-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 15/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A826810 | (05) | CA |
I42244 | (02) | CA |