Provider Demographics
NPI:1861729592
Name:JANARDHAN GRANDHE MD A MEDICAL CORPORATION
Entity type:Organization
Organization Name:JANARDHAN GRANDHE MD A MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANARDHAN
Authorized Official - Middle Name:RAO
Authorized Official - Last Name:GRANDHE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-333-4042
Mailing Address - Street 1:2012 NORWICH WAY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-2910
Mailing Address - Country:US
Mailing Address - Phone:661-333-4042
Mailing Address - Fax:661-665-1050
Practice Address - Street 1:1805 E FIR AVE
Practice Address - Street 2:#104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3859
Practice Address - Country:US
Practice Address - Phone:559-321-8510
Practice Address - Fax:559-321-8512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-18
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52798207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty