Provider Demographics
NPI:1194725390
Name:MURTHY, RAGHU C (MD)
Entity type:Individual
Prefix:
First Name:RAGHU
Middle Name:C
Last Name:MURTHY
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 1:435 N BEDFORD DR
Mailing Address - Street 2:PENTHOUSE WEST
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4321
Mailing Address - Country:US
Mailing Address - Phone:310-275-4949
Mailing Address - Fax:310-275-3777
Practice Address - Street 1:435 N BEDFORD DR
Practice Address - Street 2:PENTHOUSE WEST
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4321
Practice Address - Country:US
Practice Address - Phone:310-275-4949
Practice Address - Fax:310-275-3777
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66228207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH63265Medicare UPIN