Organization
MYSORE R NAGARAJA,M.D.,INC
Active
Organization
MYSORE R NAGARAJA,M.D.,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MYSORE R NAGARAJA MD (PRESIDENT)
(818) 363-3105
Entity
Organization
Contact information
Practice address
17075 DEVONSHIRE ST, SUITE 200, NORTHRIDGE, CA 91325-1600
(818) 363-3105
(818) 363-6178
Mailing address
17075 DEVONSHIRE ST, SUITE 200, NORTHRIDGE, CA 91325-1600
(818) 363-3105
(818) 363-6178
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A25685
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A256850
—
CA
Enumeration date
02/20/2007
Last updated
09/15/2023
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