Provider Demographics
NPI:1487350575
Name:ADAM RAJOULH M.D.
Entity type:Organization
Organization Name:ADAM RAJOULH M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAJOULH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-421-0602
Mailing Address - Street 1:3320 KAWEAH AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-3903
Mailing Address - Country:US
Mailing Address - Phone:313-421-0602
Mailing Address - Fax:
Practice Address - Street 1:3320 KAWEAH AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93619-3903
Practice Address - Country:US
Practice Address - Phone:313-421-0602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANONEMedicaid