Provider Demographics
NPI:1710950977
Name:ESWARAN, KALI S (MD)
Entity Type:Individual
Prefix:DR
First Name:KALI
Middle Name:S
Last Name:ESWARAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1995 ZINFANDEL DR
Mailing Address - Street 2:201
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-2862
Mailing Address - Country:US
Mailing Address - Phone:916-852-6001
Mailing Address - Fax:916-852-6007
Practice Address - Street 1:1995 ZINFANDEL DR
Practice Address - Street 2:201
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-2862
Practice Address - Country:US
Practice Address - Phone:916-852-6001
Practice Address - Fax:916-852-6007
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA40842207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA29221Medicare UPIN
CA00A408420Medicare ID - Type Unspecified