Provider Demographics
NPI:1487834131
Name:WADHWANI, RITA RAKESH (MD)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:RAKESH
Last Name:WADHWANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RITA
Other - Middle Name:
Other - Last Name:KEWALRAMANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:43850 N MORAY ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-5940
Mailing Address - Country:US
Mailing Address - Phone:510-371-0333
Mailing Address - Fax:
Practice Address - Street 1:43850 N MORAY ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-5940
Practice Address - Country:US
Practice Address - Phone:510-371-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-10
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97163208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics