Provider Demographics
NPI:1912989773
Name:ALAPATI, RAVINDRA (MD)
Entity Type:Individual
Prefix:
First Name:RAVINDRA
Middle Name:
Last Name:ALAPATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1771 W ROMNEYA DR
Mailing Address - Street 2:STE C
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1817
Mailing Address - Country:US
Mailing Address - Phone:714-758-0403
Mailing Address - Fax:714-917-0785
Practice Address - Street 1:1771 W ROMNEYA DR
Practice Address - Street 2:STE C
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1817
Practice Address - Country:US
Practice Address - Phone:714-758-0403
Practice Address - Fax:714-917-0785
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45634207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A456340Medicaid
00A456340424OtherCALOPTIMA
100015946OtherRR MEDICARE
100016965OtherRR MEDICARE
CA00A456340Medicaid
100016965OtherRR MEDICARE
100015946OtherRR MEDICARE
CAWA45634HMedicare ID - Type Unspecified