Provider Demographics
NPI:1851428981
Name:ABDUL CADER, NISHA (MD)
Entity Type:Individual
Prefix:DR
First Name:NISHA
Middle Name:
Last Name:ABDUL CADER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 NASELLA LN
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-4765
Mailing Address - Country:US
Mailing Address - Phone:805-547-1635
Mailing Address - Fax:805-547-1636
Practice Address - Street 1:2925 MCMILLAN AVE
Practice Address - Street 2:#103
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-6765
Practice Address - Country:US
Practice Address - Phone:805-547-1650
Practice Address - Fax:805-547-1995
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA062847208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics