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Rajesh Supra
Student in an Organized Health Care Education/Training Program in Modesto, California
NPI 1083497085

Rajesh Supra is a Student in an Organized Health Care Education/Training Program based in Pittsburg, CA. Rajesh Supra practices in Modesto, CA. The NPI Number for Rajesh Supra is 1083497085 and holds a License No. (California).

The current practice location address for Rajesh Supra is 1400 Florida Ave Ste 102, Modesto, CA and can be reached out via phone at 209-573-6181.

Location: 1400 Florida Ave Ste 102, Modesto, CA, 94565-7921
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1083497085
Provider Name
Rajesh Supra
Credential
Provider Entity Type
Individual
Gender
Male
Address
1400 Florida Ave Ste 102, Modesto, CA, 94565-7921
Phone Number
209-573-6181
Fax Number
Provider Enumeration Date
08/15/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1400 Florida Ave Ste 102
City
Modesto
State
California
Zip
95350-4446
Phone Number
209-573-6181
Fax Number
person
Provider Business Mailing Address Details
Address
1400 Florida Ave Ste 102
City
Modesto
State
California
Zip
95350-4446
Phone Number
209-573-6181
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
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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