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General NPI Number Information
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NPI Number | 1689863482
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Entity Type | Organization
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Legal Business Name | NIMISH R KADAKIA, MD, INC.
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 10/17/2007
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Provider Practice Location Address
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Address Line | 16300 SAND CANYON AVENUE SUITE 511
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City | IRVINE
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State | CA
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Zip | 92618-3705
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Country | US
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Telephone | 949-727-3636
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Fax | 949-727-9515
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Provider Business Mailing Address
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Address Line | 16300 SAND CANYON AVENUE SUITE 511
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City | IRVINE
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State | CA
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Zip | 92618-3705
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Country | US
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Telephone | 949-727-3636
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Fax | 949-727-9515
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Authorized Official
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Title or Position | OWNER
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Name | DR. NIMISH RAJ KADAKIA
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Credential | MD
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Telephone | 949-727-3636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A79590
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License Number State | CA
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