Provider Demographics
NPI:1598140550
Name:PARASHETTE, VANI (MD)
Entity Type:Individual
Prefix:
First Name:VANI
Middle Name:
Last Name:PARASHETTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VANI
Other - Middle Name:
Other - Last Name:KOBAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 UNIVERSITY OF NEW MEXICO
Mailing Address - Street 2:MSC11 6093
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131
Mailing Address - Country:US
Mailing Address - Phone:505-272-6225
Mailing Address - Fax:505-272-5184
Practice Address - Street 1:621 N STATE ST STE 3
Practice Address - Street 2:
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92583-6568
Practice Address - Country:US
Practice Address - Phone:951-652-6522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-20
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM390200000X
CAA167818208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program