Provider Demographics
NPI:1992752166
Name:RAO, ISHU V (MD)
Entity type:Individual
Prefix:
First Name:ISHU
Middle Name:V
Last Name:RAO
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 1:168 N BRENT ST
Mailing Address - Street 2:SUITE 503
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2817
Mailing Address - Country:US
Mailing Address - Phone:805-653-0101
Mailing Address - Fax:805-643-6285
Practice Address - Street 1:168 N BRENT ST
Practice Address - Street 2:SUITE 503
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2817
Practice Address - Country:US
Practice Address - Phone:805-653-0101
Practice Address - Fax:805-643-6285
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6258207RC0000X
CAA68864207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX039302702Medicaid
TX039302703Medicaid
TXP00147745OtherRR MCARE
TX8C0919Medicare ID - Type Unspecified
TX039302703Medicaid
TXP00147745OtherRR MCARE