Healthcare Provider Details

I. General information

NPI: 1174534069
Provider Name (Legal Business Name): ANURADHA RAO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 09/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9001 S H ST
BAKERSFIELD CA
93307-5948
US

IV. Provider business mailing address

PO BOX 1559
BAKERSFIELD CA
93302-1559
US

V. Phone/Fax

Practice location:
  • Phone: 661-328-4260
  • Fax: 661-617-2888
Mailing address:
  • Phone: 661-635-3050
  • Fax: 661-635-3070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberA54982
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: