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NPI Code Detail

MEDICARE: VINAY V.R. KEESARA M.D.

MEDICARE: VINAY V.R. KEESARA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RI0011XInterventional Cardiology PhysicianA44003CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033150933
Entity Type Code : Individual
Provider Name (Legal Business Name) : VINAY V.R. KEESARA M.D.
Provider Business Mailing Address
First Line : 9375 SAN FERNANDO ROAD
Second Line :
City : SUN VALLEY
State : CA
Zip : 91352
Country : US
Telephone Number : 818-504-4700
Fax Number : 818-504-4690
Provider Business Practice Location Address
First Line : 9375 SAN FERNANDO RD
Second Line :
City : SUN VALLEY
State : CA
Zip : 91352-1418
Country : US
Telephone Number : 818-768-3000
Fax Number : 818-504-4690
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2006
Last Update Date : 07/27/2010

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