Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A26699 | CA |
N | 111NI0900X | Internist | A26699 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | A26699 | CA |
NPI | 1003919655 |
---|---|
Provider Name | Mr. Narakanti Nimmagadda Rao |
First Address | Corona, CA 92882 |
Second Address | Corona, CA 92882 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A266991 | (05) | CA |
D37930 | (02) |