MEDICARE: ROOHI RAVINDRA BYAKOD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	2084P0800X	Psychiatry Physician	A-201389	CA

General Provider Information

NPI Number	:	1033806484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROOHI RAVINDRA BYAKOD MD

Provider Business Mailing Address
First Line	:	400 N PEPPER AVE
Second Line	:
City	:	COLTON
State	:	CA
Zip	:	92324-1801
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 N PEPPER AVE
Second Line	:
City	:	COLTON
State	:	CA
Zip	:	92324-1801
Country	:	US
Telephone Number	:	510-525-6927
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2023
Last Update Date	:	03/05/2026

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