Provider Demographics
NPI:1114949104
Name:KADAKIA, DARSHANA RAJESH (MD)
Entity Type:Individual
Prefix:DR
First Name:DARSHANA
Middle Name:RAJESH
Last Name:KADAKIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 S EL CAMINO REAL
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-4279
Mailing Address - Country:US
Mailing Address - Phone:949-492-4994
Mailing Address - Fax:949-492-8517
Practice Address - Street 1:910 S EL CAMINO REAL
Practice Address - Street 2:SUITE A
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-4279
Practice Address - Country:US
Practice Address - Phone:949-492-4994
Practice Address - Fax:949-492-8517
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41856207RC0200X, 207RG0300X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
F08900Medicare UPIN
CAA41856Medicare ID - Type Unspecified