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Organization
NR DEVARAJ MD INC
Active
Organization
NR DEVARAJ MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSIE FRAUSTO (PRACTICE MANAGER)
(714) 952-0958
Entity
Organization
Contact information
Practice address
3356 W. BALL RD SUITE 205, ANAHEIM, CA 92804-3737
(714) 952-0958
(714) 952-0719
Mailing address
3356 W BALL RD SUITE 205, ANAHEIM, CA 92804-3737
(714) 952-0958
(714) 952-0719
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A34201
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A342010
—
CA
Enumeration date
11/01/2006
Last updated
10/08/2020
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