Provider Demographics
NPI:1548453830
Name:KAUSHAL, MANIKA VERMA (MD)
Entity type:Individual
Prefix:
First Name:MANIKA
Middle Name:VERMA
Last Name:KAUSHAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6475 CAMDEN AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95120-2847
Mailing Address - Country:US
Mailing Address - Phone:408-997-9155
Mailing Address - Fax:408-997-9106
Practice Address - Street 1:6475 CAMDEN AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95120-2846
Practice Address - Country:US
Practice Address - Phone:408-997-9155
Practice Address - Fax:408-997-9106
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2024-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA97286207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine