Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | A39025 | CA |
NPI | 1083773667 |
---|---|
Provider Name | Bhavani S. Rao |
First Address | Panorama City, CA 91402-5423 |
Second Address | Panorama City, CA 91402-5423 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 01/12/2021 |