Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A102452 | CA |
NPI | 1043447972 |
---|---|
Provider Name | Priya Rajendran |
First Address | Mountain View, CA 94040-6203 |
Second Address | Dublin, CA 94568-3112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2009 |
Last Update Date | 19/12/2011 |