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General NPI Number Information
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NPI Number | 1740330810
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Entity Type | Organization
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Legal Business Name | PRASAD D. MUMMANENI, M.D.,INC.
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1700 N ROSE AVE STE 350
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City | OXNARD
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State | CA
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Zip | 93030-3790
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Country | US
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Telephone | 805-983-0208
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Fax | 805-981-0565
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Provider Business Mailing Address
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Address Line | 1700 N ROSE AVE STE 350
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City | OXNARD
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State | CA
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Zip | 93030-3790
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Country | US
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Telephone | 805-983-0208
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Fax | 805-981-0565
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. DONNA SOUZA
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Credential |
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Telephone | 805-983-0208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A35782
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License Number State | CA
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