Provider Demographics
NPI:1609579069
Name:SIRISH NAKKA MD INC
Entity Type:Organization
Organization Name:SIRISH NAKKA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIRISH
Authorized Official - Middle Name:
Authorized Official - Last Name:NAKKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:844-387-5337
Mailing Address - Street 1:1665 DOMINICAN WAY STE 222
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065-1515
Mailing Address - Country:US
Mailing Address - Phone:844-387-5337
Mailing Address - Fax:
Practice Address - Street 1:1665 DOMINICAN WAY STE 222
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-1515
Practice Address - Country:US
Practice Address - Phone:844-387-5337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Single Specialty