Healthcare Provider Details

I. General information

NPI: 1861753220
Provider Name (Legal Business Name): PADMAVATHI ANAND TALCHERKAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2012
Last Update Date: 06/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 S FULLER AVE APT 403E
LOS ANGELES CA
90036-5368
US

IV. Provider business mailing address

430 S FULLER AVE APT 403E
LOS ANGELES CA
90036-5368
US

V. Phone/Fax

Practice location:
  • Phone: 323-513-2073
  • Fax: 213-736-7742
Mailing address:
  • Phone: 323-513-2073
  • Fax: 213-736-7742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC51572
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: