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General NPI Number Information
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NPI Number | 1851684930
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Entity Type | Organization
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Legal Business Name | RAJEEV SHUKLA MD INC
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Dates
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Enumeration Date | 05/23/2011
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 854 S. FAIRMONT AVE SUITE #1
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City | LODI
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State | CA
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Zip | 95240-3971
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Country | US
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Telephone | 209-242-5385
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Fax | 209-224-8132
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Provider Business Mailing Address
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Address Line | 845 S FAIRMONT AVE STE 135
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City | LODI
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State | CA
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Zip | 95240-3971
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Country | US
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Telephone | 209-224-5385
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Fax | 202-224-8132
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Authorized Official
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Title or Position | OWNER
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Name | RAJEEV SHUKLA
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Credential | MD
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Telephone | 209-224-5385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A51690
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License Number State | CA
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