Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | C50114 | CA |
N | 207QA0505X | Family Doctor - Adult Medicine | C50114 | CA |
N | 207QS0010X | Family Doctor - Sports Medicine | C50114 | CA |
NPI | 1750581096 |
---|---|
Provider Name | Dr. Rajiv Kumra |
First Address | San Jose, CA 95129-3911 |
Second Address | San Jose, CA 95127-4117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2007 |
Last Update Date | 13/05/2020 |