Provider Demographics
NPI:1871535732
Name:VISVESHWARA, NADARASA (MD)
Entity type:Individual
Prefix:DR
First Name:NADARASA
Middle Name:
Last Name:VISVESHWARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2776 W WRENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-2561
Mailing Address - Country:US
Mailing Address - Phone:559-439-5367
Mailing Address - Fax:559-353-8048
Practice Address - Street 1:9300 VALLEY CHILDRENS PL
Practice Address - Street 2:SW19
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-8761
Practice Address - Country:US
Practice Address - Phone:559-353-6262
Practice Address - Fax:559-353-8048
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA266862080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine