Provider Demographics
NPI:1518970755
Name:BISWAS, MIMI SEN (MD, MHS)
Entity Type:Individual
Prefix:DR
First Name:MIMI
Middle Name:SEN
Last Name:BISWAS
Suffix:
Gender:F
Credentials:MD, MHS
Other - Prefix:DR
Other - First Name:MIMI
Other - Middle Name:
Other - Last Name:SENGUPTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3770 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2527
Mailing Address - Country:US
Mailing Address - Phone:951-352-3937
Mailing Address - Fax:951-352-2839
Practice Address - Street 1:3770 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2527
Practice Address - Country:US
Practice Address - Phone:951-352-3937
Practice Address - Fax:951-352-2839
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66654207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease