Provider Demographics
NPI:1487718151
Name:KESWANI, VAISHALI A (OD)
Entity type:Individual
Prefix:
First Name:VAISHALI
Middle Name:A
Last Name:KESWANI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:VAISHALI
Other - Middle Name:A
Other - Last Name:RAJA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5390 GREENWILLOW LN
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-6841
Mailing Address - Country:US
Mailing Address - Phone:630-803-5922
Mailing Address - Fax:858-272-0026
Practice Address - Street 1:3895 CLAIREMONT DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-5833
Practice Address - Country:US
Practice Address - Phone:630-803-5922
Practice Address - Fax:858-272-0026
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-900145152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist