Provider Demographics
NPI:1629272208
Name:MERLA, NISCHITA (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:NISCHITA
Middle Name:
Last Name:MERLA
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:MS
Other - First Name:NISCHITA
Other - Middle Name:KAMIREDDY
Other - Last Name:REDDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1330 SAN BERNARDINO RD STE L
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4980
Mailing Address - Country:US
Mailing Address - Phone:909-833-7556
Mailing Address - Fax:909-833-9226
Practice Address - Street 1:1330 SAN BERNARDINO RD STE L
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4980
Practice Address - Country:US
Practice Address - Phone:909-833-7556
Practice Address - Fax:909-833-9226
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP2-0029547207R00000X
TXN4029207RG0100X
CAA119042207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
944598860OtherMYUTMB 944598860-COMMERCIAL NUMBER
CACB209709Medicare PIN
CAFS436XMedicare PIN