Provider Demographics
NPI:1932341963
Name:DASU, VANI (DO)
Entity Type:Individual
Prefix:
First Name:VANI
Middle Name:
Last Name:DASU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 21ST ST STE 301
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3108
Mailing Address - Country:US
Mailing Address - Phone:661-324-0300
Mailing Address - Fax:
Practice Address - Street 1:3200 21ST ST STE 301
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3108
Practice Address - Country:US
Practice Address - Phone:661-324-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12890207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACD4582Medicare PIN
CAZZZ34009ZMedicare PIN
CACA133299Medicare PIN
CAP01398119Medicare PIN