S Ava Mahapatra MD a Prof Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

License

A37578 Issued in CA

Legal business name

S AVA MAHAPATRA MD A PROF CORPORATION

Practice address

1180 N Indian Canyon Dr
Suite W-210
Palm Springs, CA 92262-4800

Phone

(760) 323-2225

Fax

(760) 323-1147

NPI assigned

Aug 20, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Shakti Ava Mahapatra, M.D.

Title

President

Phone

(760) 323-2225

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282262400000",
    "number": "1013223601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 N INDIAN CANYON DR",
            "address_2": "SUITE W-210",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624800",
            "telephone_number": "760-323-2225",
            "fax_number": "760-323-1147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 N INDIAN CANYON DR",
            "address_2": "SUITE W-210",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624800",
            "telephone_number": "760-323-2225",
            "fax_number": "760-323-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S AVA MAHAPATRA MD A PROF CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-20",
        "last_updated": "2010-08-20",
        "status": "A",
        "authorized_official_last_name": "MAHAPATRA",
        "authorized_official_first_name": "SHAKTI",
        "authorized_official_middle_name": "AVA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-323-2225",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A37578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Palm Springs, CA
• Providers in Palm Springs, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.