Individual provider · Type 1 NPI

Rajesh Supra

Student in an Organized Health Care Education/Training Program · Modesto, CA

NPI number 1083497085 Active

Practice location

1400 Florida Ave Ste 102
Modesto, CA 95350-4446

Call (209) 573-6181 Map

Mailing address

2800 Romora Bay Dr
Pittsburg, CA 94565-7921

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1083497085

Rajesh Supra's National Provider Identifier is 1083497085, issued on Aug 15, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Modesto, CA. The record was last updated on Aug 15, 2023.