MEDICARE: DR. SANGEETHA POTTY MURTHY 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	207R00000X	Internal Medicine Physician	A84950	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	A84950	OTHER	CA	LICENSE

General Provider Information

NPI Number	:	1053393843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANGEETHA POTTY MURTHY MD

Provider Business Mailing Address
First Line	:	2020 GENESEE AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-4219
Country	:	US
Telephone Number	:	858-499-2710
Fax Number	:

Provider Business Practice Location Address
First Line	:	7830 CLAIREMONT MESA BLVD
Second Line	:	SUITE 287
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-1619
Country	:	US
Telephone Number	:	858-874-8741
Fax Number	:	888-420-4642

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

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	03/11/2020

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