Organization
PAIN ASSOCIATES OF MERCED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMAKRISHNA THORDAPU MD (GROUP PRESIDENT)
(209) 724-0316
Entity
Organization
Contact information
Practice address
1390 E YOSEMITE AVE, SUITE C, MERCED, CA 95348
(209) 724-0316
(209) 724-0318
Mailing address
1390 E YOSEMITE AVE STE C, MERCED, CA 95340-8221
(209) 724-0316
(209) 724-0318
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
607297600
US DEPT OF LABOR
CA
05
—
GR0099950
—
CA
01
—
ZZZ64470Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
05/22/2006
Last updated
06/26/2019
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