Organization
PRAJAKTA DESHPANDE, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRAJAKTA ABHIJIT DESHPANDE MD (MD, DIRECTOR)
(714) 252-9150
Entity
Organization
Contact information
Practice address
6800 LINCOLN AVE, SUITE 203 B, BUENA PARK, CA 90620-4162
(714) 252-9150
(714) 252-9157
Mailing address
PO BOX 8051, YAKIMA, WA 98908-0051
(714) 252-9150
(714) 252-9157
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD133444
CA
207QS1201X
Sleep Medicine (Family Medicine) Physician
Primary
MD133444
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024822
BL
CA
Enumeration date
12/17/2014
Last updated
12/17/2014
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