Provider Demographics
NPI:1346397536
Name:MADAN, ASHIMA (MD)
Entity Type:Individual
Prefix:
First Name:ASHIMA
Middle Name:
Last Name:MADAN
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 1:525 SOUTH DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4213
Mailing Address - Country:US
Mailing Address - Phone:650-968-8891
Mailing Address - Fax:
Practice Address - Street 1:525 SOUTH DR
Practice Address - Street 2:SUITE 201
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4213
Practice Address - Country:US
Practice Address - Phone:650-968-8891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44142208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A441420Medicaid
CA00A441420Medicaid