Provider Demographics
NPI:1588742761
Name:RAMA, ANITA KOTAMRAJU (MD)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:KOTAMRAJU
Last Name:RAMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:K
Other - Last Name:RAMA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2425 EAST STREET #14
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520
Mailing Address - Country:US
Mailing Address - Phone:925-676-7622
Mailing Address - Fax:
Practice Address - Street 1:2425 EAST STREET #14
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520
Practice Address - Country:US
Practice Address - Phone:925-676-7622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34584207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A34840OtherBLUE SHIELD
CA00A345842Medicare ID - Type Unspecified
CA00A34840OtherBLUE SHIELD
CA00A345842Medicare PIN