Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 243420 | NY |
Y | 2080P0216X | Pediatric Rheumatologist | A115365 | CA |
NPI | 1700043361 |
---|---|
Provider Name | Anusha Ramanathan |
First Address | Los Angeles, CA 90028-7900 |
Second Address | Los Angeles, CA 90027-6062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2008 |
Last Update Date | 22/11/2021 |