Healthcare Provider Details

I. General information

NPI: 1902915622
Provider Name (Legal Business Name): DARSHANA H VAISHNAV MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 MOORPARK AVE SUITE 319
SAN JOSE CA
95128
US

IV. Provider business mailing address

2400 MOORPARK AVE SUITE 319
SAN JOSE CA
95128
US

V. Phone/Fax

Practice location:
  • Phone: 408-975-2763
  • Fax: 408-975-2764
Mailing address:
  • Phone: 408-975-2763
  • Fax: 408-975-2764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA39869
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: