Provider Demographics
NPI:1942479639
Name:MURALIDHARAN, ASHA
Entity type:Individual
Prefix:DR
First Name:ASHA
Middle Name:
Last Name:MURALIDHARAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15005 NORTHWIND LN
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-7829
Mailing Address - Country:US
Mailing Address - Phone:818-920-0810
Mailing Address - Fax:
Practice Address - Street 1:15005 NORTHWIND LN
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-7829
Practice Address - Country:US
Practice Address - Phone:818-920-0810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56745122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist