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General NPI Number Information
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NPI Number | 1699869412
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Entity Type | Individual
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Provider Name | MONISHA RAO M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2438 PONDEROSA DRIVE NORTH SUITE NUMBER C209
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City | CAMARILLO
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State | CA
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Zip | 93012
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Country | US
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Telephone | 805-482-0721
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Fax |
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Provider Business Mailing Address
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Address Line | 4668 PASEO MARAVILLA
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City | CAMARILLO
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State | CA
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Zip | 93012-4001
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Country | US
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Telephone | 805-384-2309
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A72862
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License Number State | CA
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