Basic Information
Provider Information
NPI: 1649250424
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NACCASHA
FirstName: NIHAL
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 CASA ST
Address2: SUITE D-3
City: SAN LUIS OBISPO
State: CA
PostalCode: 934051883
CountryCode: US
TelephoneNumber: 8055462057
FaxNumber: 8057840895
Practice Location
Address1: 100 CASA ST
Address2: SUITE D-3
City: SAN LUIS OBISPO
State: CA
PostalCode: 934051883
CountryCode: US
TelephoneNumber: 8055462057
FaxNumber: 8057840895
Other Information
ProviderEnumerationDate: 01/18/2006
LastUpdateDate: 07/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VM0101XA77210CAY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine

No ID Information.


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