Provider Demographics
NPI:1053780189
Name:KADAKIA, SALONI (DO)
Entity type:Individual
Prefix:
First Name:SALONI
Middle Name:
Last Name:KADAKIA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26122 VIA CALIFORNIA
Mailing Address - Street 2:
Mailing Address - City:CAPISTRANO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92624-1202
Mailing Address - Country:US
Mailing Address - Phone:310-944-8030
Mailing Address - Fax:
Practice Address - Street 1:4327 GOLDEN CENTER DR
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-6287
Practice Address - Country:US
Practice Address - Phone:530-621-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-18
Last Update Date:2022-11-16
Deactivation Date:2018-03-05
Deactivation Code:
Reactivation Date:2018-05-09
Provider Licenses
StateLicense IDTaxonomies
CA20A16992207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty