Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 53896 | CA |
NPI | 1154598415 |
---|---|
Provider Name | Rohit Batheja |
First Address | Lakewood, CA 90713-2307 |
Second Address | Lakewood, CA 90713-2307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2008 |
Last Update Date | 14/05/2008 |