# RAJESH J KADAKIA M D A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** San Clemente Medi Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639268139
- **Authorized official:** DR. RAJESH J KADAKIA MD (OWNER PRESIDENT)
- **Authorized official phone:** (949) 492-4994

## Contact information

- **Practice address:** 910 S EL CAMINO REAL, SAN CLEMENTE, CA 92672-4279
- **Practice address phone:** (949) 492-4994
- **Practice address fax:** (949) 492-8517
- **Mailing address:** 910 S EL CAMINO REAL, SAN CLEMENTE, CA 92672-4279
- **Mailing address phone:** (949) 492-4994
- **Mailing address fax:** (949) 492-8517

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | NULL | Yes |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | — | Yes |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | NULL | — |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | — | — |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | — | NULL | — |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 10/12/2006
- **Last updated:** 03/25/2010