Provider Demographics
NPI:1982268900
Name:RAO, HINDU MALYADRI (PHARMD)
Entity type:Individual
Prefix:
First Name:HINDU
Middle Name:MALYADRI
Last Name:RAO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9401 JERONIMO RD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-1908
Mailing Address - Country:US
Mailing Address - Phone:714-833-7607
Mailing Address - Fax:
Practice Address - Street 1:9401 JERONIMO RD
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-1908
Practice Address - Country:US
Practice Address - Phone:714-833-7607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78768183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist