Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | A54982 | CA |
NPI | 1174534069 |
---|---|
Provider Name | Dr. Anuradha Rao |
First Address | Bakersfield, CA 93302-1559 |
Second Address | Bakersfield, CA 93307-5948 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 30/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A549820 | (05) | CA |
H40469 | (02) | CA |