Provider Demographics
NPI:1932130663
Name:RAMBHATLA, KAMALAKAR S (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMALAKAR
Middle Name:S
Last Name:RAMBHATLA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3580 SANTA ANITA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-2455
Mailing Address - Country:US
Mailing Address - Phone:626-442-3700
Mailing Address - Fax:626-442-3710
Practice Address - Street 1:3580 SANTA ANITA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-2455
Practice Address - Country:US
Practice Address - Phone:626-442-3700
Practice Address - Fax:626-442-3710
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2010-02-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA32691207RP1001X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A326910Medicaid
A26892Medicare UPIN
W16856Medicare ID - Type Unspecified