# SANGAMITRA KOTHAPA M D INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225356215
- **Authorized official:** SANGAMITRA KOTHAPA M.D (OWNER)
- **Authorized official phone:** (714) 825-0940

## Contact information

- **Practice address:** 1226 N BROADWAY, SANTA ANA, CA 92701-3412
- **Practice address phone:** (714) 825-0940
- **Practice address fax:** (714) 825-0944
- **Mailing address:** 1226 N BROADWAY, SANTA ANA, CA 92701-3412
- **Mailing address phone:** (714) 825-0940
- **Mailing address fax:** (714) 825-0944

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | A43502 | CA | Yes |

## Other

- **Enumeration date:** 05/14/2010
- **Last updated:** 04/04/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1407841620 | — | CA |