Provider Demographics
NPI:1497795223
Name:PAINTAL, NITA (MD)
Entity Type:Individual
Prefix:MRS
First Name:NITA
Middle Name:
Last Name:PAINTAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NITA
Other - Middle Name:
Other - Last Name:SCRINIVAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 609001
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92160-9001
Mailing Address - Country:US
Mailing Address - Phone:619-528-4600
Mailing Address - Fax:619-528-4625
Practice Address - Street 1:4700 SPRING ST
Practice Address - Street 2:SUITE 220
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-5263
Practice Address - Country:US
Practice Address - Phone:619-667-3380
Practice Address - Fax:619-667-0815
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA612202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW416Medicare PIN
CAH01417Medicare UPIN
CAWA61220AMedicare PIN