Provider Demographics
NPI:1780066480
Name:CHOWDARY, NAGA RAMYA (MD)
Entity type:Individual
Prefix:
First Name:NAGA RAMYA
Middle Name:
Last Name:CHOWDARY
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 1:122A E FOOTHILL BLVD # 360
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-2505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1750 HUNTINGTON DR STE B
Practice Address - Street 2:
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-2536
Practice Address - Country:US
Practice Address - Phone:951-684-8020
Practice Address - Fax:951-684-8090
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA156327208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA22-2540851Medicaid