Provider Demographics
NPI:1124255351
Name:KASULA, PADMA NAINA REDDY (MD)
Entity type:Individual
Prefix:DR
First Name:PADMA NAINA
Middle Name:REDDY
Last Name:KASULA
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 1:8701 DELGANY AVE
Mailing Address - Street 2:# 212
Mailing Address - City:PLAYA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90293-8188
Mailing Address - Country:US
Mailing Address - Phone:310-699-2105
Mailing Address - Fax:
Practice Address - Street 1:8701 DELGANY AVE
Practice Address - Street 2:# 212
Practice Address - City:PLAYA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90293-8188
Practice Address - Country:US
Practice Address - Phone:310-699-2105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98731207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine