Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A79106 | CA |
NPI | 1063423226 |
---|---|
Provider Name | Rajiv Bhatnagar |
First Address | Los Altos, CA 94022-1408 |
Second Address | San Carlos, CA 94070-2603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 20/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H98318 | (02) | CA |