Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | DRM 00000050 | CA |
NPI | 1801095435 |
---|---|
Provider Name | Prof. Nagesh P Rao |
First Address | Los Angeles, CA 90024-2704 |
Second Address | Los Angeles, CA 90024-2704 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2007 |
Last Update Date | 13/07/2007 |