Provider Demographics
NPI:1386649556
Name:KAMATH, RAM K (MD)
Entity Type:Individual
Prefix:
First Name:RAM
Middle Name:K
Last Name:KAMATH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAM
Other - Middle Name:K
Other - Last Name:KAMATH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2400
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-0045
Mailing Address - Country:US
Mailing Address - Phone:760-946-4840
Mailing Address - Fax:760-946-4740
Practice Address - Street 1:19015 TOWN CENTER DR
Practice Address - Street 2:STE 101
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92308-8943
Practice Address - Country:US
Practice Address - Phone:760-247-0581
Practice Address - Fax:760-247-3611
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46329207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110212888OtherRAILROAD
CAZZZ61434ZOtherBLUE CROSS/SHIELD
CA00A463290Medicaid
CA00A463290Medicaid
110212888OtherRAILROAD