Provider Demographics
NPI:1003932930
Name:RAMA L R NANDIPATI M D INC
Entity Type:Organization
Organization Name:RAMA L R NANDIPATI M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMA
Authorized Official - Middle Name:L R
Authorized Official - Last Name:NANDIPATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-725-1112
Mailing Address - Street 1:450 E YOSEMITE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-8429
Mailing Address - Country:US
Mailing Address - Phone:209-725-1112
Mailing Address - Fax:209-725-1117
Practice Address - Street 1:450 E YOSEMITE AVE STE A
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-8429
Practice Address - Country:US
Practice Address - Phone:209-725-1112
Practice Address - Fax:209-725-1117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46021207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ04884ZMedicare PIN