Healthcare Provider Details

I. General information

NPI: 1245954767
Provider Name (Legal Business Name): APOORVA THIMMA RAJU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2022
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 GLENDALE LN
SACRAMENTO CA
95825-2431
US

IV. Provider business mailing address

2400 GLENDALE LN
SACRAMENTO CA
95825-2431
US

V. Phone/Fax

Practice location:
  • Phone: 916-454-2345
  • Fax:
Mailing address:
  • Phone: 916-454-2345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA201356
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: