Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036113185 | IL |
N | 111NI0900X | Internist | 036113185 | IL |
N | 207RC0000X | Internist - Cardiovascular Disease | 4301087508 | MI |
Y | 207RI0011X | Interventional Cardiology | A112163 | CA |
NPI | 1124090303 |
---|---|
Provider Name | Sanjay Bhojraj |
First Address | Murrieta, CA 92563-1402 |
Second Address | Murrieta, CA 92563-5459 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 11/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A112163 | STATE LICENSE (01) | CA |
I48105 | (02) |