Organization
PATABI RAJ SEETHARAMAN MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATABI RAJ SEETHARAMAN M.D. (OWNER)
(330) 998-3198
Entity
Organization
Contact information
Practice address
4043 IRVING PL APT 109, CULVER CITY, CA 90232-2964
(330) 998-3198
Mailing address
4043 IRVING PL APT 109, CULVER CITY, CA 90232-2964
(330) 998-3198
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
35057803
OH
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0897374
—
OH
01
—
9287993
MEDICARE GROUP
—
01
—
CM1431
MEDICARE ID TYPE UNSPECIFIED
OH
Enumeration date
12/10/2007
Last updated
09/24/2023
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