Individual
MADHAVI MUMMANENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
805 W LA VETA AVE STE 101, ORANGE, CA 92868-3928
(714) 628-3136
Mailing address
805 W LA VETA AVE STE 101, ORANGE, CA 92868-3928
(714) 835-1800
(714) 835-1811
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
A52454
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A524540734
—
CA
01
—
WA52454A
PPIN
—
Enumeration date
05/16/2006
Last updated
06/05/2024
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