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General NPI Number Information
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NPI Number | 1841587474
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Entity Type | Individual
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Provider Name | NIMISHA DOSHI KHANNA M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/04/2011
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Last Update Date | 11/18/2021
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Provider Practice Location Address
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Address Line | 12554 RIATA VISTA CIR
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City | AUSTIN
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State | TX
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Zip | 78727-6431
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Country | US
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Telephone | 512-795-5100
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Fax | 512-795-5122
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Provider Business Mailing Address
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Address Line | 4647 ZION AVE
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City | SAN DIEGO
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State | CA
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Zip | 92120-2507
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Country | US
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Telephone | 833-574-2273
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4301098549
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A160478
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | R4074
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2016-01119
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License Number State | NC
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