Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A122557 | CA |
Y | 2084N0402X | Child Neurologist | A122557 | CA |
NPI | 1104144690 |
---|---|
Provider Name | Rajsekar Ram Rajaraman |
First Address | Tinton Falls, NJ 07724-2880 |
Second Address | Los Angeles, CA 90095-3075 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2010 |
Last Update Date | 16/11/2020 |