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General NPI Number Information
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NPI Number | 1760671234
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Entity Type | Organization
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Legal Business Name | NILESH DESAI MD INC
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Dates
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Enumeration Date | 10/19/2007
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Last Update Date | 06/27/2011
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Provider Practice Location Address
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Address Line | 241 W OLIVE AVE
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City | BURBANK
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State | CA
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Zip | 91502-1825
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Country | US
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Telephone | 818-848-5561
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Fax |
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Provider Business Mailing Address
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Address Line | 241 W OLIVE AVE
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City | BURBANK
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State | CA
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Zip | 91502-1825
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Country | US
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Telephone | 818-848-5561
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. NILESH DESAI
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Credential | M.D.
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Telephone | 818-848-5561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | A33861
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License Number State | CA
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