Provider Demographics
NPI:1811045412
Name:PRASAD, SRIDHAR KASINADHUNI (MD)
Entity Type:Individual
Prefix:DR
First Name:SRIDHAR
Middle Name:KASINADHUNI
Last Name:PRASAD
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 1:10724 WILSHIRE BLVD
Mailing Address - Street 2:APT 510
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-4447
Mailing Address - Country:US
Mailing Address - Phone:213-324-6236
Mailing Address - Fax:
Practice Address - Street 1:10724 WILSHIRE BLVD
Practice Address - Street 2:APT 510
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-4447
Practice Address - Country:US
Practice Address - Phone:213-324-6236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75286207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease