Provider Demographics
NPI:1821003203
Name:KANUNGO, ANURADHA (MD)
Entity type:Individual
Prefix:DR
First Name:ANURADHA
Middle Name:
Last Name:KANUNGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANURADHA
Other - Middle Name:
Other - Last Name:KANUNGO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6044 ROSELLE MEADOWS TRL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-6904
Mailing Address - Country:US
Mailing Address - Phone:858-350-4744
Mailing Address - Fax:
Practice Address - Street 1:2110 RUTHERFORD RD
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-7328
Practice Address - Country:US
Practice Address - Phone:760-516-5120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95848207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology