Provider Demographics
NPI:1053689372
Name:SARVA RAMA MURTHI, VIKRAM NAGA PRASAD (MD)
Entity Type:Individual
Prefix:DR
First Name:VIKRAM NAGA PRASAD
Middle Name:
Last Name:SARVA RAMA MURTHI
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 1:1040 FLYNN RD
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-5092
Mailing Address - Country:US
Mailing Address - Phone:805-673-3930
Mailing Address - Fax:805-659-3217
Practice Address - Street 1:1200 N VENTURA RD
Practice Address - Street 2:SUITE E
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-3863
Practice Address - Country:US
Practice Address - Phone:805-988-0053
Practice Address - Fax:805-988-0554
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA132393208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program