Healthcare Provider Details

I. General information

NPI: 1740431246
Provider Name (Legal Business Name): RAJESH KUMAR MAHESHWARI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2008
Last Update Date: 11/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9140 ALCOSTA BLVD SUITE D
SAN RAMON CA
94583-3858
US

IV. Provider business mailing address

9140 ALCOSTA BLVD SUITE D
SAN RAMON CA
94583-3858
US

V. Phone/Fax

Practice location:
  • Phone: 925-361-5959
  • Fax: 925-999-0375
Mailing address:
  • Phone: 925-361-5959
  • Fax: 925-999-0375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA109707
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: