Healthcare Provider Details

I. General information

NPI: 1750537684
Provider Name (Legal Business Name): TUSHAR DOSHI MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2008
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4121 BROCKTON AVE STE 104
RIVERSIDE CA
92501-3442
US

IV. Provider business mailing address

PO BOX 7547
NEWPORT BEACH CA
92658-7547
US

V. Phone/Fax

Practice location:
  • Phone: 760-399-2201
  • Fax: 949-715-6865
Mailing address:
  • Phone: 760-399-2201
  • Fax: 949-715-6865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA053572
License Number StateCA

VIII. Authorized Official

Name: DR. TUSHAR RAMNIK DOSHI
Title or Position: PRESIDENT
Credential: MD
Phone: 760-399-2201