Healthcare Provider Details

I. General information

NPI: 1104187566
Provider Name (Legal Business Name): AMAN RAJPAL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2012
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7677 OAKPORT ST
OAKLAND CA
94621-1929
US

IV. Provider business mailing address

7677 OAKPORT ST
OAKLAND CA
94621-1929
US

V. Phone/Fax

Practice location:
  • Phone: 347-705-3477
  • Fax:
Mailing address:
  • Phone: 347-705-3477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number178412
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number130378
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: