Basic Information
Provider Information
NPI: 1912171000
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KALAPATAPU
FirstName: RAJKUMAR
MiddleName: KIRAN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1001 POTRERO AVE
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941103518
CountryCode: US
TelephoneNumber: 4152068125
FaxNumber: 4157043244
Practice Location
Address1: 1001 POTRERO AVE
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941103518
CountryCode: US
TelephoneNumber: 4152068125
FaxNumber: 4157043244
Other Information
ProviderEnumerationDate: 04/18/2008
LastUpdateDate: 11/24/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XA121239CAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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