Provider Demographics
NPI:1558390880
Name:RAO, ADUPA (MD)
Entity Type:Individual
Prefix:DR
First Name:ADUPA
Middle Name:
Last Name:RAO
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:PO BOX 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:323-442-5100
Mailing Address - Fax:
Practice Address - Street 1:1520 SAN PABLO ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-5310
Practice Address - Country:US
Practice Address - Phone:323-442-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62170207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A621700OtherBLUE SHIELD
CA00A621700Medicaid
CAW18762OtherMEDICARE GROUP ID
CA1902846306OtherGROUP NPI
CACE1617OtherGOURP RAILROAD MEDICARE
CAGR0016910OtherGROUP MEDICAID PIN
CA00A621700197OtherCAL OPTIMA
CA290014741OtherRAILROAD MEDICARE
CAGR0100430OtherGROUP MEDICAL
CA290014741OtherRAILROAD MEDICARE
CAWA62170CMedicare PIN