Individual
RAVIKIRAN VEGASANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
608 E ORANGEBURG AVE, MODESTO, CA 95350-5513
(209) 529-2645
(209) 529-3024
Mailing address
608 E ORANGEBURG AVE, MODESTO, CA 95350-5513
(209) 529-2645
(209) 529-3024
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
35122842
OH
207RN0300X
Nephrology Physician
Primary
A129459
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0103941
—
OH
01
—
CA272453
MEDICARE
CA
Enumeration date
11/17/2008
Last updated
04/25/2018
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