Provider Demographics
NPI:1871726901
Name:VISHWANATH, SAHANA (MD)
Entity type:Individual
Prefix:
First Name:SAHANA
Middle Name:
Last Name:VISHWANATH
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:PO BOX 842384
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90084-2384
Mailing Address - Country:US
Mailing Address - Phone:559-603-7470
Mailing Address - Fax:
Practice Address - Street 1:684 MEDICAL CENTER DR E STE 105
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6806
Practice Address - Country:US
Practice Address - Phone:559-472-9716
Practice Address - Fax:559-472-9872
Is Sole Proprietor?:No
Enumeration Date:2009-08-24
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09464700207R00000X, 207KA0200X
CAA129024207KA0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine