Healthcare Provider Details

I. General information

NPI: 1548544166
Provider Name (Legal Business Name): RAMA THIRU PATHI MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2011
Last Update Date: 10/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18145 HIGHWAY 18 SUITE D
APPLE VALLEY CA
92307-2210
US

IV. Provider business mailing address

18145 HIGHWAY 18 SUITE D
APPLE VALLEY CA
92307-2210
US

V. Phone/Fax

Practice location:
  • Phone: 760-946-0020
  • Fax: 760-946-0710
Mailing address:
  • Phone: 760-946-0020
  • Fax: 760-946-0710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: RAMA THIRU PATHI
Title or Position: PRESIDENT
Credential: M.D., F.A.C.S.
Phone: 760-946-0020