Provider Demographics
NPI:1720061633
Name:VIRADIA, PIYUSH R (MD)
Entity type:Individual
Prefix:
First Name:PIYUSH
Middle Name:R
Last Name:VIRADIA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6405 DAY ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-0901
Mailing Address - Country:US
Mailing Address - Phone:951-697-5454
Mailing Address - Fax:951-653-3975
Practice Address - Street 1:6405 DAY ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-0901
Practice Address - Country:US
Practice Address - Phone:951-697-5453
Practice Address - Fax:951-653-3975
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39926207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ92058ZOtherGROUP SITE LOCATION
OOA399260Medicare ID - Type Unspecified
ZZZ92058ZOtherGROUP SITE LOCATION