Gangadhar, Kiran
Gangadhar, Kiran is an individual health care provider with primary practice located at 2428 Santa Monica Blvd , Santa Monica CA 90404-2045. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nuclear Medicine, Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Gangadhar, Kiran can be contacted via phone (310) 315-1000.Contact Information
Primary practice address
2428 Santa Monica Blvd
Santa Monica CA 90404-2045
Phone: (310) 315-1000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nuclear Medicine | 207U00000X | MD60751368 | Washington |
| Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | MD60751368 | Washington |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD60751368 | Washington |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | A179353 | California |
Profile Details
| NPI number | 1679906580 |
|---|---|
| LBN Legal business name | Gangadhar, Kiran |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 14th, 2013 |
| Last updated | Nov 21st, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679906580 | NPPES |
| Washington | MEDICAID | 2036468 | |
| Washington | Other | 0390732 | |
| Washington | Other | 0390731 | |
| Washington | Other | 0390729 | |
| Washington | Other | 0390730 | |
| Washington | MEDICAID | 1679906580 |
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