Provider Demographics
NPI:1295880615
Name:SARMA, RADHA J (MBBS)
Entity type:Individual
Prefix:DR
First Name:RADHA
Middle Name:J
Last Name:SARMA
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:DR
Other - First Name:RADHA
Other - Middle Name:
Other - Last Name:KAIPA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MBBS
Mailing Address - Street 1:11301 WILSHIRE BLVD
Mailing Address - Street 2:111E
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90073-1003
Mailing Address - Country:US
Mailing Address - Phone:310-478-3711
Mailing Address - Fax:
Practice Address - Street 1:11301 WILSHIRE BLVD
Practice Address - Street 2:111E
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90073-1003
Practice Address - Country:US
Practice Address - Phone:310-478-3711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2016-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25963207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFZ916ZOtherMEDICARE SOUTHERN CALIF