Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 25MA08083600 | NJ |
Y | 2080P0208X | Pediatric Infectious Diseases | A103917 | CA |
N | 2080P0208X | Pediatric Infectious Diseases | ME109493 | FL |
NPI | 1538260393 |
---|---|
Provider Name | Dr. Vini Vijayan |
First Address | Madera, CA 93636-8761 |
Second Address | Madera, CA 93636-8761 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 13/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003570400 | (05) | FL |
1538260393 | (05) | CA |