Provider Demographics
NPI:1922059849
Name:RAO, VYSHALI S (MD)
Entity Type:Individual
Prefix:DR
First Name:VYSHALI
Middle Name:S
Last Name:RAO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3452 E FOOTHILL BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3142
Mailing Address - Country:US
Mailing Address - Phone:626-793-2885
Mailing Address - Fax:626-793-6262
Practice Address - Street 1:625 S FAIR OAKS AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2613
Practice Address - Country:US
Practice Address - Phone:626-793-4139
Practice Address - Fax:626-793-4324
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2020-02-26
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Provider Licenses
StateLicense IDTaxonomies
CAA72520207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI32818Medicare UPIN
CAWA72520AMedicare PIN