1659685105 NPI number — KRITHIKA RAMADAS MD, A PROFESSIONAL CORP

Table of content: MRS. ALISON RUTH TRISE OTR (NPI 1770706186)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659685105 NPI number — KRITHIKA RAMADAS MD, A PROFESSIONAL CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KRITHIKA RAMADAS MD, A PROFESSIONAL CORP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659685105
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/11/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2100 LYNN ROAD
Provider Second Line Business Mailing Address:
SUITE 225
Provider Business Mailing Address City Name:
THOUSAND OAKS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91360-8037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-496-2726
Provider Business Mailing Address Fax Number:
805-379-1416

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2100 LYNN ROAD
Provider Second Line Business Practice Location Address:
SUITE 225
Provider Business Practice Location Address City Name:
THOUSAND OAKS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91360-8037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-496-2726
Provider Business Practice Location Address Fax Number:
805-379-1416
Provider Enumeration Date:
07/27/2010

Additional Information

Authorized Official

Authorized Official Last Name:
RAMADAS
Authorized Official First Name:
KRITHIKA
Authorized Official Middle Name:
Authorized Official Title or Position:
MD/OWNER
Authorized Official Telephone Number:
805-496-2726

Provider Taxonomy Codes

  • Taxonomy code: 207KI0005X , with the licence number:  A35950 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207KA0200X , with the licence number: A35950 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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