Individual
DR. VENU PRABAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7339 EL CAJON BLVD, SUITE I, LA MESA, CA 91941-3435
(619) 698-0606
(619) 698-0609
Mailing address
7339 EL CAJON BLVD, SUITE I, LA MESA, CA 91941-3435
(619) 698-0606
(619) 698-0609
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A42653
CA
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
A042653
CA
Other
Enumeration date
05/09/2006
Last updated
12/01/2017
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