Healthcare Provider Details

I. General information

NPI: 1225320039
Provider Name (Legal Business Name): ASHA GOPALAN NAIR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2011
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 ASHBY AVE
BERKELEY CA
94705-2067
US

IV. Provider business mailing address

2450 ASHBY AVE
BERKELEY CA
94705-2066
US

V. Phone/Fax

Practice location:
  • Phone: 510-204-4444
  • Fax: 510-649-8287
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberA157984
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberA157984
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA157984
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: