Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | A93219 | CA |
NPI | 1053450767 |
---|---|
Provider Name | Dr. Kavitha Pandy Raj |
First Address | Pleasanton, CA 94588-4054 |
Second Address | Pleasanton, CA 94588-4054 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 11/08/2016 |