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General NPI Number Information
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NPI Number | 1902178304
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Entity Type | Individual
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Provider Name | VAMSHIDHARA R GADE M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/31/2012
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Last Update Date | 11/20/2019
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Provider Practice Location Address
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Address Line | 7215 N FRESNO ST STE 103
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City | FRESNO
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State | CA
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Zip | 93720
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Country | US
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Telephone | 559-438-1111
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Fax | 559-438-4002
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Provider Business Mailing Address
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Address Line | 7215 N FRESNO ST STE 103
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City | FRESNO
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State | CA
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Zip | 93720-2969
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Country | US
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Telephone | 559-438-1111
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Fax | 559-438-4002
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A122369
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | A122369
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License Number State | CA
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