Individual
NITIN K PRABHAKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
340 NORTHLAKE DR, SAN JOSE, CA 95117-1251
(872) 231-3162
Mailing address
PO BOX 7410882, CHICAGO, IL 60674-0882
(702) 899-0595
(702) 977-1496
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
A164044
CA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
164044
CA
Other
Enumeration date
05/17/2018
Last updated
10/13/2025
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