MEDICARE: VISHESH ANAND PERSAUD M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	MD225681	OR

General Provider Information

NPI Number	:	1235665720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VISHESH ANAND PERSAUD M.D

Provider Business Mailing Address
First Line	:	2111 EXCHANGE ST
Second Line	:
City	:	ASTORIA
State	:	OR
Zip	:	97103-3329
Country	:	US
Telephone Number	:	503-325-4321
Fax Number	:

Provider Business Practice Location Address
First Line	:	2158 EXCHANGE ST STE 302
Second Line	:
City	:	ASTORIA
State	:	OR
Zip	:	97103-3307
Country	:	US
Telephone Number	:	503-338-4516
Fax Number	:	503-338-4574

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2017
Last Update Date	:	05/05/2026

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