Provider Demographics
NPI:1710329099
Name:NAGRAMPA, DUSTIN MEDINA (MD)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:MEDINA
Last Name:NAGRAMPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 E 31ST ST
Mailing Address - Street 2:DEPT OF INTERNAL MEDICINE
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-1018
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1411 EAST 31ST STREET
Practice Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-2546
Practice Address - Country:US
Practice Address - Phone:510-535-7618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-26
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program