Provider Demographics
NPI:1427866417
Name:KAUSHIK, VISHAL SR
Entity type:Individual
Prefix:
First Name:VISHAL
Middle Name:
Last Name:KAUSHIK
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 BALDWIN AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-4700
Mailing Address - Country:US
Mailing Address - Phone:615-562-2927
Mailing Address - Fax:
Practice Address - Street 1:3815 BALDWIN AVE APT 5
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-4700
Practice Address - Country:US
Practice Address - Phone:615-562-2927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-21
Last Update Date:2024-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty