Provider Demographics
NPI:1043233109
Name:MURTHY, NIRMALA (MD)
Entity Type:Individual
Prefix:DR
First Name:NIRMALA
Middle Name:
Last Name:MURTHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18523 CORWIN RD
Mailing Address - Street 2:STE H
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2338
Mailing Address - Country:US
Mailing Address - Phone:760-242-3000
Mailing Address - Fax:760-242-1802
Practice Address - Street 1:18523 CORWIN RD
Practice Address - Street 2:STE H
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2338
Practice Address - Country:US
Practice Address - Phone:760-242-3000
Practice Address - Fax:760-242-1802
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA431240208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE30282Medicare UPIN