Basic Information
| Provider Information | |||||||||
| NPI: | 1831825900 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NAGAMBIKA MUNAGANURU MD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24001 CALLE DE LA MAGDALENA | ||||||||
| Address2: | PO BOX 3391 | ||||||||
| City: | LAGUNA HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926549998 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9256833391 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8700 BEVERLY BLVD | ||||||||
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| City: | WEST HOLLYWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900481804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104233277 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2022 | ||||||||
| LastUpdateDate: | 07/29/2022 | ||||||||
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| AuthorizedOfficialLastName: | MUNAGANURU | ||||||||
| AuthorizedOfficialFirstName: | NAGAMBIKA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9256835704 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 07/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.