Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 44584 | AZ |
N | 208000000X | Pediatrician | C54276 | CA |
N | 2080P0202X | Pediatric Cardiologist | 44584 | AZ |
N | 2080P0202X | Pediatric Cardiologist | C54276 | CA |
N | 2080P0203X | Pediatric Critical Care Doctor | 44584 | AZ |
Y | 2080P0203X | Pediatric Critical Care Doctor | C54276 | CA |
NPI | 1063452779 |
---|---|
Provider Name | Rohit P Rao |
First Address | San Diego, CA 92123-4223 |
Second Address | San Diego, CA 92123-4223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32620300 | (05) | WI |
635030 | (05) | AZ |
H10531 | (02) |