Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 40244 | CA |
N | 2251H1300X | Human Factors | 40244 | CA |
N | 225XH1300X | Human Factors | 40244 | CA |
NPI | 1962086025 |
---|---|
Provider Name | Ruchika Rai Challagulla |
First Address | San Diego, CA 92130-8745 |
Second Address | San Diego, CA 92130-8745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2021 |
Last Update Date | 05/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F7830716 | DMV (01) | CA |