Provider Demographics
NPI:1245295666
Name:ADATIA, NAVIN H (MD)
Entity type:Individual
Prefix:
First Name:NAVIN
Middle Name:H
Last Name:ADATIA
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:PO BOX 6397
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-6397
Mailing Address - Country:US
Mailing Address - Phone:626-285-2248
Mailing Address - Fax:626-285-6790
Practice Address - Street 1:4519 N ROSEMEAD BLVD
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1476
Practice Address - Country:US
Practice Address - Phone:626-285-2248
Practice Address - Fax:626-285-6790
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA369882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
075001OtherPACIFICARE
CA00A369880Medicaid
075001OtherPACIFICARE
A36988Medicare ID - Type Unspecified