Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 182634 | CA |
N | 207R00000X | Internist | C52104 | CA |
N | 111NI0900X | Internist | C52104 | CA |
Y | 207RC0200X | Critical Care Medicine | C52104 | CA |
N | 207RP1001X | Pulmonary Disease | C52104 | CA |
NPI | 1497776041 |
---|---|
Provider Name | Dr. Hari Nagaraj |
First Address | Sacramento, CA 95825-2296 |
Second Address | Roseville, CA 95661 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 30/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H41336 | (02) | CA |
H41336 | (02) | KY |