Provider Demographics
NPI:1407959315
Name:ADAPA, RAMANA (MD)
Entity Type:Individual
Prefix:
First Name:RAMANA
Middle Name:
Last Name:ADAPA
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 1:652 W 11TH ST
Mailing Address - Street 2:SUITE 137
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-3869
Mailing Address - Country:US
Mailing Address - Phone:209-833-7555
Mailing Address - Fax:209-833-7518
Practice Address - Street 1:652 W 11TH ST
Practice Address - Street 2:SUITE 137
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-3869
Practice Address - Country:US
Practice Address - Phone:209-833-7555
Practice Address - Fax:209-833-7518
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA851262083P0500X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine