Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 036127599 | IL |
NPI | 1215237276 |
---|---|
Provider Name | Dr. Rakhi Yadav |
First Address | San Jose, CA 95125-4919 |
Second Address | San Jose, CA 95128-1633 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2010 |
Last Update Date | 11/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
GZ317A | MEDICARE GROUP PTAN (01) | CA |