| Dr Ramaiah Indudhara, MD | |
|
751 W Legion Rd Ste 305, Brawley, CA 92227-7755 | |
| (760) 351-4444 | |
| (760) 344-7106 |
| Full Name | Dr Ramaiah Indudhara |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 42 Years |
| Location | 751 W Legion Rd Ste 305, Brawley, California |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538116215 | NPI | - | NPPES |
| 200573670A | Medicaid | OK | |
| A81435 | Other | CA | CA LICENSE |
| G18611 | Other | CA | SO CA MEDICARE PTAN |
| 201107550A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | A81435 (California) | Primary |
| 208800000X | Urology | 04-37795 (Kansas) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Pioneers Memorial Healthcare District | Brawley, CA | Hospital |
| Enloe Medical Center | Chico, CA | Hospital |
| El Centro Regional Medical Center | El centro, CA | Hospital |
| Entity Name | Enloe Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396753281 PECOS PAC ID: 9739092388 Enrollment ID: O20031110000404 |
| Entity Name | Enloe Medical Center |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1477975613 PECOS PAC ID: 9739092388 Enrollment ID: O20140401001696 |
| Entity Name | Valley Sunshine Medical Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386143147 PECOS PAC ID: 5092054601 Enrollment ID: O20190226002053 |
| Entity Name | Legacy Md Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073210753 PECOS PAC ID: 0446619738 Enrollment ID: O20230705001455 |
| Entity Name | Imperial Manor Skilled Nursing, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912662883 PECOS PAC ID: 4082971734 Enrollment ID: O20241004000958 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ramaiah Indudhara, MD 3311 E Murdock St, Wichita, KS 67208-3054 Ph: (316) 689-9185 | Dr Ramaiah Indudhara, MD 751 W Legion Rd Ste 305, Brawley, CA 92227-7755 Ph: (760) 351-4444 |