Individual
DR. KISHORE K VASANT I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25102 JEFFERSON AVE, SUITE # C, MURRIETA, CA 92562-1707
(951) 698-8876
(951) 698-5560
Mailing address
25102 JEFFERSON AVE, SUITE # C, MURRIETA, CA 92562-1707
(951) 698-8876
(951) 698-5560
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
A33638
CA
208000000X
Pediatrics Physician
A33638
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A336382
—
CA
Enumeration date
06/23/2006
Last updated
06/08/2012
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