Individual
DR. VENKATAPPA M PADMANABHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D FACP
Contact information
Practice address
902 E MAIN ST, BARSTOW, CA 92311-2406
(760) 255-4700
(760) 255-3840
Mailing address
902 E MAIN ST, BARSTOW, CA 92311-2406
(760) 255-4700
(760) 255-3840
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
A40810
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A408100
—
CA
Enumeration date
03/18/2006
Last updated
06/17/2010
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