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Individual

JAI V GHATNEKAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6601 WHITE FEATHER RD, STE A4, JOSHUA TREE, CA 92252-6607
(760) 366-6128
(760) 366-6130
Mailing address
PO BOX 2019, YUCCA VALLEY, CA 92286-2019
(760) 362-3777
(760) 228-2151

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01052298
IN
208600000X
Surgery Physician
C42883
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200890130
IN
01
DO365A
MEDICARE PROVIDER NUMBER
CA
Enumeration date
09/06/2006
Last updated
11/04/2010
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