Provider Demographics
NPI:1245544873
Name:NAIR, AJITHA K (DPM, MPH)
Entity type:Individual
Prefix:DR
First Name:AJITHA
Middle Name:K
Last Name:NAIR
Suffix:
Gender:F
Credentials:DPM, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2961 SUMMIT ST STE B
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3482
Mailing Address - Country:US
Mailing Address - Phone:510-775-2431
Mailing Address - Fax:415-367-1286
Practice Address - Street 1:2961 SUMMIT ST STE B
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3482
Practice Address - Country:US
Practice Address - Phone:510-775-2431
Practice Address - Fax:416-367-1286
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-06
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5074213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery