Provider Demographics
NPI:1093795684
Name:NAIDU, AJANTA (MD)
Entity Type:Individual
Prefix:
First Name:AJANTA
Middle Name:
Last Name:NAIDU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:26 HEADLAND DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-5117
Mailing Address - Country:US
Mailing Address - Phone:310-989-0713
Mailing Address - Fax:
Practice Address - Street 1:UCI MEDICAL CENTER
Practice Address - Street 2:101 THE CITY DRIVE, PAVILLION 1
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868
Practice Address - Country:US
Practice Address - Phone:714-456-7011
Practice Address - Fax:714-456-7857
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA415932080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology