Provider Demographics
NPI:1942215736
Name:KAZADI, MWANGA MURANGA (MD)
Entity Type:Individual
Prefix:
First Name:MWANGA
Middle Name:MURANGA
Last Name:KAZADI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6555 COYLE AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0302
Practice Address - Country:US
Practice Address - Phone:916-536-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70218207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A702180OtherBLUE SHIELD
CA102206OtherHEALTH NET
CA2361105OtherUNITED HEALTHCARE
CA00A702180Medicaid
CA7382484OtherAETNA
CA98461OtherINTERPLAN
CA1671630OtherGREAT WEST
CA2130957OtherFIRST HEALTH
CA4387778OtherCIGNA
CA90136461OtherPACIFICARE
CAMCMG459300OtherWESTERN HEALTH ADVANTAGE
CA000810771179OtherPACIFICARE
CAA70218OtherBLUE CROSS
H73335Medicare UPIN
CA00A702180Medicaid