Provider Demographics
NPI:1104297803
Name:JOHN, RANI SAIJU (NP)
Entity type:Individual
Prefix:MRS
First Name:RANI
Middle Name:SAIJU
Last Name:JOHN
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13302 BRASS RING LN
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92880-3490
Mailing Address - Country:US
Mailing Address - Phone:480-294-4216
Mailing Address - Fax:
Practice Address - Street 1:300 CONTINENTAL BLVD STE 635
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-5040
Practice Address - Country:US
Practice Address - Phone:562-335-2730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-07
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002474363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily