MEDICARE: MONISHA RAO M.D.

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	208000000X	Pediatrics Physician	A72862	CA

General Provider Information

NPI Number	:	1699869412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONISHA RAO M.D.

Provider Business Mailing Address
First Line	:	4668 PASEO MARAVILLA
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93012-4001
Country	:	US
Telephone Number	:	805-384-2309
Fax Number	:

Provider Business Practice Location Address
First Line	:	2438 PONDEROSA DRIVE NORTH
Second Line	:	SUITE NUMBER C209
City	:	CAMARILLO
State	:	CA
Zip	:	93012
Country	:	US
Telephone Number	:	805-482-0721
Fax Number	:

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/08/2007

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