Individual
DR. KAUSTUBH VASANT PATANKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3770 ELIZABETH ST, RIVERSIDE, CA 92506-2527
(951) 352-3937
(951) 352-2839
Mailing address
3770 ELIZABETH ST, RIVERSIDE, CA 92506-2527
(951) 352-3937
(951) 352-2839
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A43218
CA
207RC0000X
Cardiovascular Disease Physician
A43218
CA
207RI0011X
Interventional Cardiology Physician
Primary
A43218
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A432180
PIN
CA
Enumeration date
07/21/2006
Last updated
06/26/2024
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