Provider Demographics
NPI:1093959108
Name:UDANI, VIKRAM (MD)
Entity Type:Individual
Prefix:DR
First Name:VIKRAM
Middle Name:
Last Name:UDANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2381
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-2381
Mailing Address - Country:US
Mailing Address - Phone:858-598-5291
Mailing Address - Fax:858-598-5296
Practice Address - Street 1:11199 SORRENTO VALLEY RD STE 203
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1334
Practice Address - Country:US
Practice Address - Phone:619-566-0640
Practice Address - Fax:619-566-0620
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA104381207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery