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Organization
SANGAMITRA KOTHAPA M D INC
Active
Organization
SANGAMITRA KOTHAPA M D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANGAMITRA KOTHAPA M.D (OWNER)
(714) 825-0940
Entity
Organization
Contact information
Practice address
1226 N BROADWAY, SANTA ANA, CA 92701-3412
(714) 825-0940
(714) 825-0944
Mailing address
1226 N BROADWAY, SANTA ANA, CA 92701-3412
(714) 825-0940
(714) 825-0944
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A43502
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407841620
—
CA
Enumeration date
05/14/2010
Last updated
04/04/2011
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