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NPI Code Detail

MEDICARE: SHANTI NILAKANTAN MD

MEDICARE:   SHANTI  NILAKANTAN  MD
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
1207R00000XInternal Medicine PhysicianA38477CA
2207RE0101XEndocrinology, Diabetes & Metabolism PhysicianA38477CA
3207RG0300XGeriatric Medicine (Internal Medicine) PhysicianA38477CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100A384770OTHERCAMEDI CAL

General Provider Information

NPI Number : 1902805898
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANTI NILAKANTAN MD
Provider Business Mailing Address
First Line : 2925 PALO VERDE AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90815-1552
Country : US
Telephone Number : 562-429-2473
Fax Number :
Provider Business Practice Location Address
First Line : 2925 PALO VERDE AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90815-1552
Country : US
Telephone Number : 562-429-2473
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2005
Last Update Date : 01/23/2013

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Directions to “ SHANTI NILAKANTAN MD” Practice Location

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