Individual
AJAY VENKATESH SRIVASTAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1420 KETTNER BLVD STE 100, SAN DIEGO, CA 92101-5373
(844) 989-4744
Mailing address
1440 COLUMBIA ST APT 1812, SAN DIEGO, CA 92101-3481
(203) 415-7473
Taxonomy
Speciality
Code
Description
License number
State
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
A121488
CA
207RC0000X
Cardiovascular Disease Physician
A121488
CA
207UN0901X
Nuclear Cardiology Physician
A121488
CA
Other
Enumeration date
08/07/2006
Last updated
12/14/2024
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