Healthcare Provider Details

I. General information

NPI: 1306239165
Provider Name (Legal Business Name): NAUSHAD A KHERAJ, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2015
Last Update Date: 03/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3580 SANTA ANITA AVE SUITE B
EL MONTE CA
91731-2455
US

IV. Provider business mailing address

25050 AVENUE KEARNY SUITE 208
VALENCIA CA
91355-1255
US

V. Phone/Fax

Practice location:
  • Phone: 626-203-1596
  • Fax:
Mailing address:
  • Phone: 661-430-0940
  • Fax: 661-295-0862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberA38084
License Number StateCA

VIII. Authorized Official

Name: DR. NAUSHAD A KHERAJ
Title or Position: SOLE PROPRIETOR
Credential: M.D.
Phone: 626-203-1596