Healthcare Provider Details

I. General information

NPI: 1407315468
Provider Name (Legal Business Name): MS. KAJAL VERMA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 10/19/2025
Certification Date: 10/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 ILLINOIS ST
SAN FRANCISCO CA
94158-2518
US

IV. Provider business mailing address

1701 W CHARLESTON BLVD STE 290
LAS VEGAS NV
89102-2302
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-7475
  • Fax:
Mailing address:
  • Phone: 702-671-2385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberA188052
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: