Healthcare Provider Details

I. General information

NPI: 1598798043
Provider Name (Legal Business Name): VASUKI S DARAM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VASUKI S SITTAMPALAM MD

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 12/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38209 47TH ST E
PALMDALE CA
93552-3113
US

IV. Provider business mailing address

PO BOX 7007
LANCASTER CA
93539-7007
US

V. Phone/Fax

Practice location:
  • Phone: 661-726-3800
  • Fax: 661-726-3862
Mailing address:
  • Phone: 661-726-3800
  • Fax: 661-726-3862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA93866
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: