Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A108477 | CA |
N | 111NI0900X | Internist | A108477 | CA |
Y | 207RC0200X | Critical Care Medicine | A108477 | CA |
NPI | 1073742052 |
---|---|
Provider Name | Dr. Santhi Raja |
First Address | Mountain View, CA 94040-6203 |
Second Address | San Ramon, CA 94582-4677 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2009 |
Last Update Date | 01/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A108477 | STATE MEDICAL LICENSE (01) | CA |
FR1541817 | FEDERAL DEA LICENSE (01) | CA |