Individual
DR. NALLINI GNANADESIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7150 TAMPA AVE, RESEDA, CA 91335-3700
(818) 757-4447
Mailing address
4322 VANALDEN AVE, TARZANA, CA 91356-5520
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
C42560
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C42560
CA LICENSE #
CA
01
—
WC42560B
PPIN #1
CA
01
—
WC42560C
PPIN #2
CA
Enumeration date
06/30/2006
Last updated
03/07/2023
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