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General NPI Number Information
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NPI Number | 1316999550
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Entity Type | Individual
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Provider Name | MADHAVI MUMMANENI MD
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Gender | Female
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 805 W LA VETA AVE STE 101
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City | ORANGE
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State | CA
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Zip | 92868-3928
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Country | US
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Telephone | 714-628-3136
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Fax |
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Provider Business Mailing Address
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Address Line | 805 W LA VETA AVE STE 101
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City | ORANGE
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State | CA
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Zip | 92868-3928
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Country | US
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Telephone | 714-835-1800
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Fax | 714-835-1811
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | A52454
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License Number State | CA
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