Healthcare Provider Details

I. General information

NPI: 1679703599
Provider Name (Legal Business Name): NAMRATA VARMA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2009
Last Update Date: 10/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 E WARDLOW RD
LONG BEACH CA
90807-4507
US

IV. Provider business mailing address

433 E WARDLOW RD
LONG BEACH CA
90807-4507
US

V. Phone/Fax

Practice location:
  • Phone: 562-427-0550
  • Fax: 562-988-8899
Mailing address:
  • Phone: 562-427-0550
  • Fax: 562-988-8899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number20A14105
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: