Provider Demographics
NPI:1962583096
Name:NANDIPATI, RAMA LR (MD)
Entity type:Individual
Prefix:
First Name:RAMA
Middle Name:LR
Last Name:NANDIPATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:450 E YOSEMITE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-8429
Mailing Address - Country:US
Mailing Address - Phone:209-725-1112
Mailing Address - Fax:209-725-1117
Practice Address - Street 1:450 E YOSEMITE AVE STE A
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-8429
Practice Address - Country:US
Practice Address - Phone:209-725-1112
Practice Address - Fax:209-725-1117
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2015-01-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA46021207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A460210Medicare PIN