Healthcare Provider Details

I. General information

NPI: 1063777084
Provider Name (Legal Business Name): RICHA KAUSHAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 E SHAW AVE
FRESNO CA
93710-8024
US

IV. Provider business mailing address

1551 E SHAW AVE
FRESNO CA
93710-8024
US

V. Phone/Fax

Practice location:
  • Phone: 559-320-0490
  • Fax:
Mailing address:
  • Phone: 559-320-0490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA138603
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: