Provider Demographics
NPI:1619950524
Name:NAGAPPAN, ALAMELU SUBBU (MD)
Entity Type:Individual
Prefix:
First Name:ALAMELU
Middle Name:SUBBU
Last Name:NAGAPPAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7160 BROCKTON AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2614
Mailing Address - Country:US
Mailing Address - Phone:951-782-3801
Mailing Address - Fax:951-274-0403
Practice Address - Street 1:7160 BROCKTON AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3912
Practice Address - Country:US
Practice Address - Phone:951-782-3801
Practice Address - Fax:951-782-3861
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49548207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ14801ZOtherGROUP SITE LOCATION
F01597Medicare UPIN
ZZZ14801ZOtherGROUP SITE LOCATION