Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | A82932 | CA |
NPI | 1184651234 |
---|---|
Provider Name | Kalpana Sathyanarayana Rao |
First Address | Walnut Creek, CA 94595-2203 |
Second Address | Vallejo, CA 94589 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 13/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I18152 | (02) | CA |