Provider Demographics
NPI:1376633420
Name:RANGANATH, KITTANE A (MD)
Entity Type:Individual
Prefix:DR
First Name:KITTANE
Middle Name:A
Last Name:RANGANATH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:17395 TRAMONTO DRIVE
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-3118
Mailing Address - Country:US
Mailing Address - Phone:310-268-3091
Mailing Address - Fax:310-268-4983
Practice Address - Street 1:11301 WILSHIRE BLVD
Practice Address - Street 2:BUILDING 500
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90073-1003
Practice Address - Country:US
Practice Address - Phone:310-268-3091
Practice Address - Fax:310-268-4983
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA24578207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D0909730Medicare PIN