Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A79590 | CA |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | A79590 | CA |
NPI | 1194787275 |
---|---|
Provider Name | Dr. Nimish Raj Kadakia |
First Address | Laguna Woods, CA 92637-3116 |
Second Address | Irvine, CA 92618-3197 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2006 |
Last Update Date | 29/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I21250 | (02) | CA |