Provider Demographics
NPI:1972696466
Name:MANCHANDA, RAMESH K (MD)
Entity type:Individual
Prefix:DR
First Name:RAMESH
Middle Name:K
Last Name:MANCHANDA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 80624
Mailing Address - Street 2:RAMESH K MANCHANDA, MD; MEDICAL CORPORATION
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91118-8624
Mailing Address - Country:US
Mailing Address - Phone:323-307-0810
Mailing Address - Fax:323-307-0813
Practice Address - Street 1:1700 CESAR E CHAVEZ AVE
Practice Address - Street 2:SUITE 3800
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:323-307-0810
Practice Address - Fax:323-307-0913
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAA26288207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0002930Medicaid
CA00A262880OtherBLUE SHIELD
CAGR0002930Medicaid
CA00A262880OtherBLUE SHIELD