Individual
DR. MAYNIKA VANI RASTOGI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-2099
(541) 267-5151
(541) 266-4566
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-2099
(541) 267-5151
(541) 266-4566
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD23904
OR
390200000X
Student in an Organized Health Care Education/Training Program
28558
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500697714
—
OR
Enumeration date
12/16/2008
Last updated
01/30/2020
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