Provider Demographics
NPI:1003902081
Name:DALUVOY, RAO VENKATESWARA (MD)
Entity Type:Individual
Prefix:
First Name:RAO
Middle Name:VENKATESWARA
Last Name:DALUVOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15982 QUANTICO RD STE D
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-1382
Mailing Address - Country:US
Mailing Address - Phone:760-810-0920
Mailing Address - Fax:760-515-6044
Practice Address - Street 1:15982 QUANTICO RD STE D
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-1382
Practice Address - Country:US
Practice Address - Phone:760-810-0920
Practice Address - Fax:760-515-6044
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA322692086S0120X, 2086S0129X, 208C00000X, 208G00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A322690Medicaid
CA020049944OtherRAILROAD
CAA26744Medicare UPIN