Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 144190 | CA |
Y | 207RP1001X | Pulmonary Disease | 144190 | CA |
NPI | 1083925739 |
---|---|
Provider Name | Dr. Initha Rajeswari Elangovan |
First Address | Martinez, CA 94553-3156 |
Second Address | Martinez, CA 94553 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2010 |
Last Update Date | 03/11/2016 |