Provider Demographics
NPI:1568640076
Name:MISHRA, KAVITA KACHOLIA (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:KAVITA
Middle Name:KACHOLIA
Last Name:MISHRA
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1600 DIVISADERO ST # H-1031
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3010
Mailing Address - Country:US
Mailing Address - Phone:415-505-9636
Mailing Address - Fax:
Practice Address - Street 1:505 PARNASSUS AVENUE, L-08/75
Practice Address - Street 2:LONG HOSPITAL BSMT, RADIATION ONCOLOGY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143
Practice Address - Country:US
Practice Address - Phone:415-505-9636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA919342085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology