Provider Demographics
NPI:1265559694
Name:RAO, SHYAM SD (MD, PHD)
Entity type:Individual
Prefix:
First Name:SHYAM
Middle Name:SD
Last Name:RAO
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Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:4501 X ST
Mailing Address - Street 2:G0140
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2229
Mailing Address - Country:US
Mailing Address - Phone:916-734-8051
Mailing Address - Fax:916-734-5068
Practice Address - Street 1:4501 X ST
Practice Address - Street 2:G0140
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2229
Practice Address - Country:US
Practice Address - Phone:916-734-8051
Practice Address - Fax:916-734-5068
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2014-03-07
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Provider Licenses
StateLicense IDTaxonomies
MO20060137532085R0001X
NY2575442085R0001X
CAA1290532085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology