Provider Demographics
NPI:1992951115
Name:NATH, ASHOK (MD,)
Entity type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:
Last Name:NATH
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:DR
Other - First Name:ASHOK
Other - Middle Name:KUMAR
Other - Last Name:ANANTHASAYANAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3660 PARK SIERRA DR STE 203
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3071
Mailing Address - Country:US
Mailing Address - Phone:951-687-3400
Mailing Address - Fax:951-687-7630
Practice Address - Street 1:401 E HIGHLAND AVE STE 551
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-3840
Practice Address - Country:US
Practice Address - Phone:909-882-9150
Practice Address - Fax:909-883-8972
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA128657207RN0300X
NY273134207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology