Individual
RACHAKONDA D PRABHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5701 W. CHARLESTON BLVD., SUITE100, LAS VEGAS, NV 89146
(702) 877-9514
(702) 312-3510
Mailing address
5701 W. CHARLESTON BLVD., SUITE100, LAS VEGAS, NV 89146
(702) 877-9514
(702) 312-3510
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
3775
NV
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
3775
NV
207RP1001X
Pulmonary Disease Physician
Primary
3775
NV
207RS0012X
Sleep Medicine (Internal Medicine) Physician
3775
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538156633
—
NV
05
—
2002263
—
NV
01
—
XPY005470
MEDI CAL
CA
Enumeration date
10/04/2005
Last updated
10/29/2020
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