Provider Demographics
NPI:1740621010
Name:GAD, NIMISHA PRAMOD (OD)
Entity type:Individual
Prefix:
First Name:NIMISHA
Middle Name:PRAMOD
Last Name:GAD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 COLDWATER CANYON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-5162
Mailing Address - Country:US
Mailing Address - Phone:818-301-6325
Mailing Address - Fax:
Practice Address - Street 1:6801 COLDWATER CANYON AVE
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-5162
Practice Address - Country:US
Practice Address - Phone:818-301-6396
Practice Address - Fax:818-763-7231
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4894152W00000X
CAOPT33669TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist