Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 256545 | MA |
N | 111NI0900X | Internist | 256545 | MA |
Y | 207RI0011X | Interventional Cardiology | MD197284 | OR |
NPI | 1073953154 |
---|---|
Provider Name | Rohit Malhotra |
First Address | Medford, OR 97504-4314 |
Second Address | Medford, OR 97504-4314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2013 |
Last Update Date | 12/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500778801 | (05) | OR |