Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | A146393 | CA |
N | 207V00000X | Obstetrician & Gynecologist | 23055 | WV |
Y | 207V00000X | Obstetrician & Gynecologist | A146393 | CA |
NPI | 1588862478 |
---|---|
Provider Name | Dr. Vellore G Kasturi |
First Address | Fresno, CA 93721-1431 |
Second Address | Santa Maria, CA 93454-4836 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 30/06/2021 |