Provider Demographics
NPI:1689927139
Name:RAKESH DONTHINENI, M.D. INC.
Entity Type:Organization
Organization Name:RAKESH DONTHINENI, M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RAKESH
Authorized Official - Middle Name:
Authorized Official - Last Name:DONTHINENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-594-9411
Mailing Address - Street 1:5700 TELEGRAPH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1710
Mailing Address - Country:US
Mailing Address - Phone:510-594-9411
Mailing Address - Fax:510-594-2275
Practice Address - Street 1:5700 TELEGRAPH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1710
Practice Address - Country:US
Practice Address - Phone:510-594-9411
Practice Address - Fax:510-594-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2012-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3691195332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6705680001Medicare NSC