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NPI Code Detail

MEDICARE: NAREN VASUDEVAN PA

MEDICARE: NAREN VASUDEVAN PA
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
1363A00000XPhysician AssistantPA20545CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA20545OTHERCALICENSE

General Provider Information

NPI Number : 1841500626
Entity Type Code : Individual
Provider Name (Legal Business Name) : NAREN VASUDEVAN PA
Provider Business Mailing Address
First Line : 7300 MAGNOLIA AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92504-3810
Country : US
Telephone Number : 951-710-1030
Fax Number : 951-710-1040
Provider Business Practice Location Address
First Line : 7300 MAGNOLIA AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92504-3810
Country : US
Telephone Number : 951-710-1030
Fax Number : 951-710-1040
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2010
Last Update Date : 10/14/2010

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Directions to “ NAREN VASUDEVAN PA” Practice Location

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