# RAJENDRA H DWIVEDI M.D. INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295913705
- **Authorized official:** DR. RAJENDRA H DWIVEDI M.D. M.S. (UROLOGIST)
- **Authorized official phone:** (559) 781-2403

## Contact information

- **Practice address:** 623 W PUTNAM AVE, PORTERVILLE, CA 93257
- **Practice address phone:** (559) 781-2403
- **Practice address fax:** (559) 781-4334
- **Mailing address:** 623 W PUTNAM AVE, PORTERVILLE, CA 93257-3212
- **Mailing address phone:** (559) 781-2403
- **Mailing address fax:** (559) 781-4334

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 00A337030 | CA | Yes |

## Other

- **Enumeration date:** 02/06/2008
- **Last updated:** 06/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00A337030 | — | CA |