Healthcare Provider Details

I. General information

NPI: 1184019911
Provider Name (Legal Business Name): USHA RAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 E GRAND AVE
ESCONDIDO CA
92025-4405
US

IV. Provider business mailing address

637 3RD AVE
CHULA VISTA CA
91910-5707
US

V. Phone/Fax

Practice location:
  • Phone: 619-662-4100
  • Fax:
Mailing address:
  • Phone: 619-662-4100
  • Fax: 619-356-2726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA148750
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: