Provider Demographics
NPI:1659685105
Name:KRITHIKA RAMADAS MD, A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:KRITHIKA RAMADAS MD, A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRITHIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMADAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-496-2726
Mailing Address - Street 1:2100 LYNN ROAD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-8037
Mailing Address - Country:US
Mailing Address - Phone:805-496-2726
Mailing Address - Fax:805-379-1416
Practice Address - Street 1:2100 LYNN ROAD
Practice Address - Street 2:SUITE 225
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-8037
Practice Address - Country:US
Practice Address - Phone:805-496-2726
Practice Address - Fax:805-379-1416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-27
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35950207KA0200X, 207KI0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
No207KI0005XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyClinical & Laboratory ImmunologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADI099AMedicare PIN
CAA27951Medicare UPIN