Active NPI
Sr Abhyankar MD Professional Corporation
- Specialist
- Indio, CA
National Provider Identifier
1043281108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- C42869
- Legal business name
- SR ABHYANKAR MD PROFESSIONAL CORPORATION
- Practice address
- 81709 Dr Carreon Blvd
Ste C 1
Indio, CA 92201-5509 - Phone
- (760) 347-0440
- Fax
- (760) 342-0747
- NPI assigned
- Jan 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Shreedhar Ramesh P Abhyankar, MD
- Title
- MD
- Phone
- (760) 347-0440
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | C42869 | CA | Primary |
Addresses
Primary practice location
81709 Dr Carreon Blvd
Ste C 1
Indio, CA 92201-5509
Mailing address
81709 Dr Carreon Blvd
Ste C 1
Indio, CA 92201-5509
Phone (760) 347-0440
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0102750 | Medicaid | CA |
National Provider Directory
National Provider Directory- Tax ID family
- Shreedhar Ramesh P Abhyankar
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Specialist
- Indio, CA
- NPI 1992717391
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1445990400000",
"number": "1043281108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "81709 DR CARREON BLVD",
"address_2": "STE C 1",
"city": "INDIO",
"state": "CA",
"postal_code": "922015509",
"telephone_number": "760-347-0440",
"fax_number": "760-342-0747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "81709 DR CARREON BLVD",
"address_2": "STE C 1",
"city": "INDIO",
"state": "CA",
"postal_code": "922015509",
"telephone_number": "760-347-0440",
"fax_number": "760-342-0747"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SR ABHYANKAR MD PROFESSIONAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-27",
"last_updated": "2015-10-28",
"status": "A",
"authorized_official_last_name": "ABHYANKAR",
"authorized_official_first_name": "SHREEDHAR RAMESH",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "MD",
"authorized_official_telephone_number": "760-347-0440",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "CA",
"license": "C42869",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0102750",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indio, CA
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.