Healthcare Provider Details

I. General information

NPI: 1598842833
Provider Name (Legal Business Name): BHAGWAN MOORJANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/31/2025
Certification Date: 08/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35400 BOB HOPE DR STE 113
RANCHO MIRAGE CA
92270-1772
US

IV. Provider business mailing address

73115 AMBER ST
PALM DESERT CA
92260-5995
US

V. Phone/Fax

Practice location:
  • Phone: 760-328-7500
  • Fax: 760-501-0719
Mailing address:
  • Phone: 760-989-4607
  • Fax: 888-869-2328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA62033
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD34123
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA62033
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number01085231A
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberA62033
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberDR.0075883
License Number StateCO
# 7
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberA62033
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: