MEDICARE: DR P G RAJAN,MD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	A30073	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700903564
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR P G RAJAN,MD INC

Provider Business Mailing Address
First Line	:	1711 W ROMNEYA DR
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92801-1804
Country	:	US
Telephone Number	:	714-491-3900
Fax Number	:	714-491-9329

Provider Business Practice Location Address
First Line	:	1711 W ROMNEYA DR
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92801-1804
Country	:	US
Telephone Number	:	714-832-7642
Fax Number	:	714-832-7308

Authorized Official
Title or Position	:	A/R MANAGER
Name	:	MRS. GAIL FRANCES KUHN
Credential	:
Telephone Number	:	714-832-7642

Provider Enumeration Date	:	03/24/2007
Last Update Date	:	05/14/2009

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