Healthcare Provider Details

I. General information

NPI: 1710939715
Provider Name (Legal Business Name): KRITHIKA RAMADAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 06/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 LYNN ROAD SUITE 225
THOUSAND OAKS CA
91360-8037
US

IV. Provider business mailing address

2100 LYNN ROAD SUITE 225
THOUSAND OAKS CA
91360-8037
US

V. Phone/Fax

Practice location:
  • Phone: 805-496-2726
  • Fax: 805-379-1416
Mailing address:
  • Phone: 805-496-2726
  • Fax: 805-379-1416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberA35950
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207KI0005X
TaxonomyClinical & Laboratory Immunology (Allergy & Immunology) Physician
License NumberA35950
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: