Basic Information
| Provider Information | |||||||||
| NPI: | 1417134040 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WADHWA | ||||||||
| FirstName: | VIKRAM | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | NEUROVASCULAR MEDICAL GROUP UCSF MEDICAL CENTER | ||||||||
| Address2: | 505 PARNASSUS AVE, L352 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941430001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4153531869 | ||||||||
| FaxNumber: | 4153538606 | ||||||||
| Practice Location | |||||||||
| Address1: | NEUROVASCULAR MEDICAL GROUP UCSF MEDICAL CENTER | ||||||||
| Address2: | 505 PARNASSUS AVE, L352 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941430001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4153531869 | ||||||||
| FaxNumber: | 4153538606 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2008 | ||||||||
| LastUpdateDate: | 01/25/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085N0700X | A102605 | CA | Y | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2085R0202X | A102605 | CA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.