Individual
DR. NANDHITHA NATESAN THAIYANANTHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1520 SAN PABLO ST, SUITE 1000, LOS ANGELES, CA 90033-5310
(323) 442-5100
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A 104377
CA
207RP1001X
Pulmonary Disease Physician
Primary
A 104377
CA
208M00000X
Hospitalist Physician
044770
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
044770
CT PHYSICIAN LICENSE
CT
01
—
1902846306
GROUP NPI
CA
01
—
40780
CT CSR
CT
01
—
DD5799
GROUP RAILROAD MEDICARE
CA
01
—
GR0100430
GROUP MEDICAID PIN
CA
01
—
W18762
GROUP MEDICARE PIN
CA
Enumeration date
12/28/2006
Last updated
03/07/2023
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