Provider Demographics
NPI:1447468798
Name:KESALA, RENATA LARISSA (DO)
Entity type:Individual
Prefix:DR
First Name:RENATA
Middle Name:LARISSA
Last Name:KESALA
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:3600 MINNESOTA DR STE 800
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-7915
Mailing Address - Country:US
Mailing Address - Phone:952-595-1301
Mailing Address - Fax:612-294-4903
Practice Address - Street 1:3600 MINNESOTA DR STE 800
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-7915
Practice Address - Country:US
Practice Address - Phone:952-595-1301
Practice Address - Fax:612-294-4903
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2025-01-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A93362085R0202X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology