Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A168099 | CA |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | A168099 | CA |
NPI | 1104212083 |
---|---|
Provider Name | Shrey Kanjiya |
First Address | Stony Brook, NY 11794-8181 |
Second Address | Los Angeles, CA 90045-1543 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2015 |
Last Update Date | 27/08/2021 |