Provider Demographics
NPI:1710773056
Name:MENON, VYSHNAV RAJAGOPAL (MD)
Entity type:Individual
Prefix:MR
First Name:VYSHNAV
Middle Name:RAJAGOPAL
Last Name:MENON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CENTINELLA HOSPITAL MEDICAL CENTER, PROGRAM INTERNAL ME
Mailing Address - Street 2:555 E HARDY ST, INGLEWOOD
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90301
Mailing Address - Country:US
Mailing Address - Phone:310-673-4660
Mailing Address - Fax:
Practice Address - Street 1:CENTINELLA HOSPITAL MEDICAL CENTER, PROGRAM INTERNAL ME
Practice Address - Street 2:555 E HARDY ST, INGLEWOOD
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90301
Practice Address - Country:US
Practice Address - Phone:310-673-4660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty