Healthcare Provider Details

I. General information

NPI: 1538855325
Provider Name (Legal Business Name): MR. RAHUL NATARAJAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 CENTRAL AVE STE 4
RIVERSIDE CA
92506-5912
US

IV. Provider business mailing address

1720 E CESAR E CHAVEZ AVE
LOS ANGELES CA
90033-2414
US

V. Phone/Fax

Practice location:
  • Phone: 951-355-2956
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE6229
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: