Provider Demographics
NPI:1710723887
Name:DESAI, MAHARAJ SHASHI (PHD)
Entity type:Individual
Prefix:MR
First Name:MAHARAJ
Middle Name:SHASHI
Last Name:DESAI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:RAJU
Other - Middle Name:
Other - Last Name:DESAI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:35 S MAGNOLIA AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-3002
Mailing Address - Country:US
Mailing Address - Phone:415-370-0656
Mailing Address - Fax:
Practice Address - Street 1:1001 POTRERO AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:628-206-5279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program