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Individual
NEELESH S BANGALORE
Active
Individual
NEELESH S BANGALORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A70883
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A708831
—
CA
01
—
00A708832
MEDI CAL
CA
01
—
900085684
TAX ID
CA
01
—
DC7234
RAILROAD
CA
01
—
P00186385
RAILROAD
CA
01
—
ZZZ08571Z
BLUE SHIELD
CA
Enumeration date
06/15/2005
Last updated
06/25/2012
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