Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | A99911 | CA |
NPI | 1033388616 |
---|---|
Provider Name | Soumya G Rao |
First Address | Poway, CA 92064-2437 |
Second Address | Poway, CA 92064-2437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2008 |
Last Update Date | 07/05/2015 |