Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301086526 | MI |
N | 111NI0900X | Internist | 4301086526 | MI |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 163037 | CA |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 4301086526 | MI |
NPI | 1083893838 |
---|---|
Provider Name | Naveen Kakumanu |
First Address | Los Altos, CA 94022-1408 |
Second Address | Fremont, CA 94538 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2007 |
Last Update Date | 03/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1083893838 | (05) | MI |