Healthcare Provider Details

I. General information

NPI: 1174029458
Provider Name (Legal Business Name): SARVESH KAUSHIK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 ADDISON ST STE 329
BERKELEY CA
94704-1192
US

IV. Provider business mailing address

156 16TH AVE
SAN FRANCISCO CA
94118-1017
US

V. Phone/Fax

Practice location:
  • Phone: 510-666-0854
  • Fax:
Mailing address:
  • Phone: 126-710-3384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA180020
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: