Provider Demographics
NPI:1003923319
Name:PRASAD, DARBHA RAO (MD)
Entity Type:Individual
Prefix:DR
First Name:DARBHA
Middle Name:RAO
Last Name:PRASAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DARBHA
Other - Middle Name:RAO
Other - Last Name:PRASAD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:500 S RANCHO DR
Mailing Address - Street 2:STE. 12
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4844
Mailing Address - Country:US
Mailing Address - Phone:702-877-1887
Mailing Address - Fax:702-877-4536
Practice Address - Street 1:500 S RANCHO DR
Practice Address - Street 2:STE. 12
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4844
Practice Address - Country:US
Practice Address - Phone:702-877-1887
Practice Address - Fax:702-877-4536
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12285207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1003923319Medicaid
NVGG937ZMedicare PIN