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General NPI Number Information
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NPI Number | 1477521342
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Entity Type | Individual
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Provider Name | BASAVARAJ NAGAPPALA MD
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Gender | Male
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1100 BUTTE ST
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City | REDDING
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State | CA
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Zip | 96001-0852
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Country | US
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Telephone | 530-241-0410
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Fax |
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Provider Business Mailing Address
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Address Line | 3116 W. MARCH LN, STE 200
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City | STOCKTON
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State | CA
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Zip | 95219-2370
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Country | US
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Telephone | 209-473-6555
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Fax | 209-473-6544
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A91561
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License Number State | CA
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