Healthcare Provider Details

I. General information

NPI: 1851951529
Provider Name (Legal Business Name): NIKHITHA MURALI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NIKITHA MURALI

II. Dates (important events)

Enumeration Date: 06/16/2019
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4733 W SUNSET BLVD FL 3
LOS ANGELES CA
90027-6021
US

IV. Provider business mailing address

4867 W SUNSET BLVD
LOS ANGELES CA
90027-5969
US

V. Phone/Fax

Practice location:
  • Phone: 833-574-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number125.078792
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number125.078792
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: