MEDICARE: DR. SANTOSH KESARI MD PHD

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
1	2084N0400X	Neurology Physician	C53829	CA
2	2084N0400X	Neurology Physician	210564	MA

General Provider Information

NPI Number	:	1891785960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANTOSH KESARI MD PHD

Provider Business Mailing Address
First Line	:	2811 WILSHIRE BLVD STE 790
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-4805
Country	:	US
Telephone Number	:	310-870-7260
Fax Number	:	310-870-8680

Provider Business Practice Location Address
First Line	:	2811 WILSHIRE BLVD STE 790
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-4805
Country	:	US
Telephone Number	:	310-870-7260
Fax Number	:	310-870-8680

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	12/02/2025

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