Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0214X | Pediatric Pulmonologist | 036.126899 | IL |
Y | 2080P0214X | Pediatric Pulmonologist | A138339 | CA |
NPI | 1588781173 |
---|---|
Provider Name | Dr. Rakesh Bhattacharjee |
First Address | San Diego, CA 92123-4223 |
Second Address | San Diego, CA 92123-2758 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 04/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4662014085 | ONTARIO HEALTH INSURANCE# (01) |