Provider Demographics
NPI:1902628258
Name:KOTHARI, NEHA N (ARDMS,RVT)
Entity type:Individual
Prefix:
First Name:NEHA
Middle Name:N
Last Name:KOTHARI
Suffix:
Gender:F
Credentials:ARDMS,RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7002 MOODY ST STE 209
Mailing Address - Street 2:
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-1177
Mailing Address - Country:US
Mailing Address - Phone:714-300-5799
Mailing Address - Fax:562-202-9377
Practice Address - Street 1:7002 MOODY ST STE 209
Practice Address - Street 2:
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-1177
Practice Address - Country:US
Practice Address - Phone:714-300-5799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1284652085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound