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General NPI Number Information
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NPI Number | 1417428731
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Entity Type | Individual
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Provider Name | VINITA R KOTHARI C-FNP
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Gender | Female
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Dates
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Enumeration Date | 12/13/2018
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 4288 KATELLA AVE
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3562
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Country | US
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Telephone | 562-548-2713
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Fax |
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Provider Business Mailing Address
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Address Line | 5287 VIA ANDALUSIA
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City | YORBA LINDA
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State | CA
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Zip | 92886-5018
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Country | US
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Telephone | 714-865-7995
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F1180657
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License Number State | CA
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