Organization
GORADIA MEDICAL CORPORATION
Active
Other names
Nervana
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TUSHAR GORADIA MD, PHD (PRESIDENT)
(916) 534-1234
Entity
Organization
Contact information
Practice address
4003 BRIDGE ST, FAIR OAKS, CA 95628-7503
(916) 534-1234
Mailing address
PO BOX 39000, DEPT# 34304, SAN FRANCISCO, CA 94139-0001
(916) 534-1234
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
G86829
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689782484
NPI
CA
Enumeration date
02/03/2010
Last updated
02/17/2010
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