Provider Demographics
NPI:1225188352
Name:BATRA, PRAMOD KUMAR SR (MD)
Entity Type:Individual
Prefix:DR
First Name:PRAMOD
Middle Name:KUMAR
Last Name:BATRA
Suffix:SR
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:1781 W ROMNEYA DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1818
Mailing Address - Country:US
Mailing Address - Phone:714-535-8882
Mailing Address - Fax:714-535-8883
Practice Address - Street 1:1781 W ROMNEYA DR
Practice Address - Street 2:SUITE G
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1818
Practice Address - Country:US
Practice Address - Phone:714-535-8882
Practice Address - Fax:714-535-8883
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA36745208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB50331Medicare UPIN