Provider Demographics
NPI:1629004528
Name:KAPADIA, PRAVIN L (MD)
Entity Type:Individual
Prefix:DR
First Name:PRAVIN
Middle Name:L
Last Name:KAPADIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11832 E. ROSECRANS AVE., SUITE 200
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-3266
Mailing Address - Country:US
Mailing Address - Phone:562-864-4004
Mailing Address - Fax:562-864-4959
Practice Address - Street 1:11832 E. ROSECRANS AVE., SUITE 200
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-3251
Practice Address - Country:US
Practice Address - Phone:562-864-4004
Practice Address - Fax:562-864-4959
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31025207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA26316Medicare UPIN