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General NPI Number Information
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NPI Number | 1487388500
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Entity Type | Organization
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Legal Business Name | EPIDAURUS MEDICAL
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Dates
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Enumeration Date | 07/14/2022
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 8821 AVIATION BLVD UNIT 88100
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City | LOS ANGELES
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State | CA
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Zip | 90009-3496
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Country | US
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Telephone | 848-228-0612
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Fax |
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Provider Business Mailing Address
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Address Line | 8821 AVIATION BLVD UNIT 88100
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City | LOS ANGELES
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State | CA
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Zip | 90009-3496
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Country | US
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Telephone | 848-228-0612
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAJ DESAI
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Credential | MD
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Telephone | 424-301-7090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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