Prithviraj Dharmaraja, MD, Inc.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

PRITHVIRAJ DHARMARAJA, MD, INC.

Practice address

41301 12TH St W Ste a
Palmdale, CA 93551-1465

Phone

(661) 726-6277

Fax

(661) 726-6291

NPI assigned

Sep 26, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Prithviraj Dharmaraja, MD

Title

Ceo

Phone

(661) 726-6277

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537920000000",
    "number": "1174008148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6168",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935396168",
            "telephone_number": "661-726-6277",
            "fax_number": "661-726-6291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41301 12TH ST W STE A",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511465",
            "telephone_number": "661-726-6277",
            "fax_number": "661-726-6291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRITHVIRAJ DHARMARAJA, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-26",
        "last_updated": "2018-09-26",
        "status": "A",
        "authorized_official_last_name": "DHARMARAJA",
        "authorized_official_first_name": "PRITHVIRAJ",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "661-726-6277",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932111424",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Palmdale, CA
• Providers in Palmdale, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.