Individual
DR. SANJIV GIRISH FALDU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2526 SISTER MARY COLUMBA DR FL 1, RED BLUFF, CA 96080-4327
(530) 528-6150
(530) 528-6196
Mailing address
3400 DATA DR, ATTN CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
34489
AZ
207RC0000X
Cardiovascular Disease Physician
Primary
C166929
CA
207RC0000X
Cardiovascular Disease Physician
MA05729100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P0136891
MEDICARE PTAN
AZ
Enumeration date
06/27/2005
Last updated
02/27/2020
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