Provider Demographics
NPI:1336448620
Name:RAMBHATLA, PRANITA VEMULAPALLI (MD)
Entity Type:Individual
Prefix:DR
First Name:PRANITA
Middle Name:VEMULAPALLI
Last Name:RAMBHATLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PRANITA
Other - Middle Name:CHOUDARY
Other - Last Name:VEMULAPALLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8950W OLYMPIC BLVD 171
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3565
Mailing Address - Country:US
Mailing Address - Phone:818-842-8000
Mailing Address - Fax:818-842-3208
Practice Address - Street 1:1101 W UNIVERSITY DR
Practice Address - Street 2:3 NORTH
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1863
Practice Address - Country:US
Practice Address - Phone:248-601-4900
Practice Address - Fax:248-601-4994
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-25
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA468686207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology