Healthcare Provider Details

I. General information

NPI: 1487672176
Provider Name (Legal Business Name): PRASH FRANCIS JAYARAJ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 E CESAR E CHAVEZ AVE SUITE 125
LOS ANGELES CA
90033-2464
US

IV. Provider business mailing address

1701 E CESAR E CHAVEZ AVE SUITE 125
LOS ANGELES CA
90033-2464
US

V. Phone/Fax

Practice location:
  • Phone: 323-441-1122
  • Fax:
Mailing address:
  • Phone: 323-441-1122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA95962
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberA95962
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: