MEDICARE: RAGHU RAM KATRAGADDA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	A78647	CA
2	207L00000X	Anesthesiology Physician	A78647	CA

General Provider Information

NPI Number	:	1851391833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAGHU RAM KATRAGADDA

Provider Business Mailing Address
First Line	:	1860 MOWRY AVE
Second Line	:	SUITE 400
City	:	FREMONT
State	:	CA
Zip	:	94538-1730
Country	:	US
Telephone Number	:	510-284-4100
Fax Number	:	510-794-9783

Provider Business Practice Location Address
First Line	:	1860 MOWRY AVE
Second Line	:	SUITE 400
City	:	FREMONT
State	:	CA
Zip	:	94538-1730
Country	:	US
Telephone Number	:	510-284-4100
Fax Number	:	510-794-9783

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	12/14/2021

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Directions to “ RAGHU RAM KATRAGADDA ” Practice Location

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