Provider Demographics
NPI:1598842833
Name:MOORJANI, BHAGWAN (MD)
Entity type:Individual
Prefix:
First Name:BHAGWAN
Middle Name:
Last Name:MOORJANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73115 AMBER ST
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-5995
Mailing Address - Country:US
Mailing Address - Phone:760-989-4607
Mailing Address - Fax:888-869-2328
Practice Address - Street 1:35400 BOB HOPE DR STE 113
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-1772
Practice Address - Country:US
Practice Address - Phone:760-328-7500
Practice Address - Fax:760-501-0719
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62033208000000X, 2084N0400X, 2084N0402X, 2084N0600X
DCMD341232084N0400X
IN01085231A2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology