MEDICARE: DR. RUSS RAJ ARJAL MD

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	036165353	IL
2	207RG0100X	Gastroenterology Physician	MD-23967	HI
3	207RG0100X	Gastroenterology Physician	MD00049187	WA
4	207RG0100X	Gastroenterology Physician	DR.0043601	CO
5	207RG0100X	Gastroenterology Physician	C171402	CA

General Provider Information

NPI Number	:	1821144403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUSS RAJ ARJAL MD

Provider Business Mailing Address
First Line	:	PO BOX 4049
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501-0449
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	134 PUUHONU WAY
Second Line	:
City	:	HILO
State	:	HI
Zip	:	96720-2066
Country	:	US
Telephone Number	:	808-969-3979
Fax Number	:	808-935-7657

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	06/03/2026

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