Organization Active NPI

Ravindra Prabhu MD a Medical Corporation

  • Clinical Cardiac Electrophysiology Physician
  • Chula Vista, CA
National Provider Identifier
1174956270
Registry record updated Sep 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
A37174 Issued in CA
Legal business name
RAVINDRA PRABHU MD A MEDICAL CORPORATION
Practice address
754 Medical Center CT.
Suite 206
Chula Vista, CA 91911-6656
Phone
(619) 482-4333
Fax
(619) 482-4445
NPI assigned
Aug 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2013

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

Authorized official

Name
Ravindra Prabhu, MD
Title
MD.
Phone
(619) 482-4333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0001X A37174 CA Primary

Addresses

Primary practice location

754 Medical Center CT.
Suite 206
Chula Vista, CA 91911-6656

Mailing address

754 Medical Center CT.
Suite 206
Chula Vista, CA 91911-6656
Phone (619) 482-4333

Other identifiers 1

IdentifierTypeStateIssuer
00A371740MedicaidCA

National Provider Directory

National Provider Directory

Locations

754 Medical Center Ct
Ste 206
Chula Vista, CA 91911
Phone (619) 482-4333

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378771200000",
    "number": "1174956270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 MEDICAL CENTER CT.",
            "address_2": "SUITE 206",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919116656",
            "telephone_number": "619-482-4333",
            "fax_number": "619-482-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "754 MEDICAL CENTER CT.",
            "address_2": "SUITE 206",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919116656",
            "telephone_number": "619-482-4333",
            "fax_number": "619-482-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVINDRA PRABHU MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-13",
        "last_updated": "2013-09-10",
        "status": "A",
        "authorized_official_last_name": "PRABHU",
        "authorized_official_first_name": "RAVINDRA",
        "authorized_official_title_or_position": "MD.",
        "authorized_official_telephone_number": "619-482-4333",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CA",
            "license": "A37174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A371740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; 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.