Provider Demographics
NPI:1659373413
Name:KAPOOR, NARESH K (MD)
Entity Type:Individual
Prefix:DR
First Name:NARESH
Middle Name:K
Last Name:KAPOOR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:175 N JACKSON AVE
Mailing Address - Street 2:STE # 212
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1909
Mailing Address - Country:US
Mailing Address - Phone:408-254-8280
Mailing Address - Fax:408-254-1089
Practice Address - Street 1:175 N JACKSON AVE
Practice Address - Street 2:STE # 212
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1909
Practice Address - Country:US
Practice Address - Phone:408-254-8280
Practice Address - Fax:408-254-1089
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2011-12-20
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Provider Licenses
StateLicense IDTaxonomies
CAA35427208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A354270Medicaid