MEDICARE: PADMA MAHAJAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A36338	CA

General Provider Information

NPI Number	:	1265547830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PADMA MAHAJAN MD

Provider Business Mailing Address
First Line	:	2242 CAMDEN AVE STE 203
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95124-2029
Country	:	US
Telephone Number	:	408-356-7161
Fax Number	:	408-356-6676

Provider Business Practice Location Address
First Line	:	2242 CAMDEN AVE STE 203
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95124-2029
Country	:	US
Telephone Number	:	408-356-7161
Fax Number	:	408-356-6676

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	07/16/2023

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