Basic Information
| Provider Information | |||||||||
| NPI: | 1417331307 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANAPALA | ||||||||
| FirstName: | RAJASEKHAR | ||||||||
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| Credential: | M.B.B.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1498 PACIFIC AVE STE 409 | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984024208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535693313 | ||||||||
| FaxNumber: | 8178872842 | ||||||||
| Practice Location | |||||||||
| Address1: | 1800 N CALIFORNIA ST | ||||||||
| Address2: | |||||||||
| City: | STOCKTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2099432000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2015 | ||||||||
| LastUpdateDate: | 07/23/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 153636 | CA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.