Provider Demographics
NPI:1982993069
Name:ATIGAPRAMOJ, NISA S (MD)
Entity Type:Individual
Prefix:
First Name:NISA
Middle Name:S
Last Name:ATIGAPRAMOJ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3860 CALLE FORTUNADA
Mailing Address - Street 2:STE 210
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4800
Mailing Address - Country:US
Mailing Address - Phone:858-309-6303
Mailing Address - Fax:858-309-6301
Practice Address - Street 1:3020 CHILDRENS WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4223
Practice Address - Country:US
Practice Address - Phone:858-966-8800
Practice Address - Fax:858-966-7433
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
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Provider Licenses
StateLicense IDTaxonomies
CAA108312208000000X, 2080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine