Basic Information
| Provider Information | |||||||||
| NPI: | 1942215736 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAZADI | ||||||||
| FirstName: | MWANGA | ||||||||
| MiddleName: | MURANGA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3400 DATA DR | ||||||||
| Address2: | |||||||||
| City: | RANCHO CORDOVA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956707956 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 6555 COYLE AVE | ||||||||
| Address2: | |||||||||
| City: | CARMICHAEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956080302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9165362500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2006 | ||||||||
| LastUpdateDate: | 02/10/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | A70218 | CA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | 207VX0000X | A70218 | CA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics |
ID Information
| ID | Type | State | Issuer | Description | 00A702180 | 01 | CA | BLUE SHIELD | OTHER | 102206 | 01 | CA | HEALTH NET | OTHER | 2361105 | 01 | CA | UNITED HEALTHCARE | OTHER | 00A702180 | 05 | CA | MEDICAID | 7382484 | 01 | CA | AETNA | OTHER | 98461 | 01 | CA | INTERPLAN | OTHER | 1671630 | 01 | CA | GREAT WEST | OTHER | 2130957 | 01 | CA | FIRST HEALTH | OTHER | 4387778 | 01 | CA | CIGNA | OTHER | 90136461 | 01 | CA | PACIFICARE | OTHER | MCMG459300 | 01 | CA | WESTERN HEALTH ADVANTAGE | OTHER | 000810771179 | 01 | CA | PACIFICARE | OTHER | A70218 | 01 | CA | BLUE CROSS | OTHER |