Individual
NISREEN MESIWALA KOTHARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
15051 HESPERIAN BLVD STE A, SAN LEANDRO, CA 94578
(510) 276-1212
Mailing address
250 KING ST UNIT 432, SAN FRANCISCO, CA 94107-5488
(248) 760-9236
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
0
PA
207W00000X
Ophthalmology Physician
262309
MA
207W00000X
Ophthalmology Physician
Primary
A144488
CA
207W00000X
Ophthalmology Physician
RS2014-0672
NM
Other
Enumeration date
04/04/2012
Last updated
07/23/2018
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