Individual
RAJENDRA KUMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CEO
Contact information
Practice address
7 W ACACIA ST, STE.3B, STOCKTON, CA 95202-1243
(209) 983-1681
(209) 983-0428
Mailing address
639 RILEY FORD LN, STOCKTON, CA 95206-6289
(209) 983-1681
(209) 983-0428
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
MTN01207F
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861579674
—
CA
Enumeration date
04/13/2017
Last updated
04/13/2017
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