Basic Information
| Provider Information | |||||||||
| NPI: | 1417301987 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOSHI | ||||||||
| FirstName: | NIVEDITA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | YADAV | ||||||||
| OtherFirstName: | NIVEDITA | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1800 N. CALIFORNIA ST. | ||||||||
| Address2: | 3 MAIN | ||||||||
| City: | STOCKTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2095475741 | ||||||||
| FaxNumber: | 2094613295 | ||||||||
| Practice Location | |||||||||
| Address1: | 1800 N. CALIFORNIA ST. | ||||||||
| Address2: | 3 MAIN | ||||||||
| City: | STOCKTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2095475741 | ||||||||
| FaxNumber: | 2094613295 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2016 | ||||||||
| LastUpdateDate: | 06/17/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A161032 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.