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Individual

MR. PRASAD D MUMMANENI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1700 NORTH ROSE AVENUE, SUITE 350, OXNARD, CA 93030
(805) 983-0208
(805) 981-0565
Mailing address
1700 NORTH ROSE AVENUE, SUITE 350, OXNARD, CA 93030
(805) 983-0208
(805) 981-0565

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A35782
CA
207RC0000X
Cardiovascular Disease Physician
Primary
A35782
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A357820
CA
01
A35782
STATE LIC
CA
Enumeration date
11/01/2006
Last updated
03/07/2023
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