| Kumara Prathipati, M.d.,inc | |
|
4276 54th Pl #b San Diego CA 92115-6011 | |
| (619) 286-3222 | |
| (619) 286-3223 |
| Full Name | Kumara Prathipati, M.d.,inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4276 54th Pl, San Diego, California |
| Authorized Official Name and Position | Kumara S Prathipati (PRESIDENT) |
| Authorized Official Contact | 6192863222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kumara Prathipati, M.d.,inc 4276 54th Pl #b San Diego CA 92115-6011 Ph: (619) 286-3222 | Kumara Prathipati, M.d.,inc 4276 54th Pl #b San Diego CA 92115-6011 Ph: (619) 286-3222 |
| NPI Number | 1780709345 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0547220675 |
|---|---|
| Medicare Enrollment ID | O20041013001040 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780709345 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A40438 (California) | Primary |
| Provider Name | Kumara S Prathipati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538267778 PECOS PAC ID: 5698848232 Enrollment ID: I20080715000943 |
| Provider Name | Lakshimi Prathipati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245338490 PECOS PAC ID: 4183796287 Enrollment ID: I20120125000430 |
| Provider Name | Nisha Kuruvadi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104322239 PECOS PAC ID: 4486904794 Enrollment ID: I20230111001560 |
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