| Dr Hanumantharao Damerla, MD, | |
|
1900 Sycamore Canyon Rd, San Dimas, CA 91773-1220 | |
| (626) 975-2968 | |
| (213) 639-1361 |
| Full Name | Dr Hanumantharao Damerla |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 1900 Sycamore Canyon Rd, San Dimas, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225119464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | A69165 (California) | Primary |
| Entity Name | County of San Bernardino |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164467023 PECOS PAC ID: 3870499130 Enrollment ID: O20031209000420 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Hanumantharao Damerla, MD, 550 S Vermont Ave, Los Angeles, CA 90020-1912 Ph: (213) 738-2902 | Dr Hanumantharao Damerla, MD, 1900 Sycamore Canyon Rd, San Dimas, CA 91773-1220 Ph: (626) 975-2968 |
Dr. Divya Krishnamoorthy, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 762 Cypress St, San Dimas, CA 91773 Phone: 909-599-1227 Fax: 206-299-9789 |
Habib Ali Ismail, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1330 W Covina Blvd, Ste 103, San Dimas, CA 91773 Phone: 909-592-2145 Fax: 909-599-6217 |
Dr. Jia Mao, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 540 E Foothill Blvd Ste 100h, San Dimas, CA 91773 Phone: 626-466-6628 |
Mohsen Ibrahim Ali, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1330 W Covina Blvd, Suite 103, San Dimas, CA 91773 Phone: 909-592-2145 Fax: 909-599-6217 |
Joshua Kritsada Koh, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1173 N Dixie Dr, Suite 101, San Dimas, CA 91773 Phone: 909-599-4422 Fax: 909-599-5577 |