Venu Prabaker, M.D.

Primary specialty

Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X

License

A042653 Issued in CA

Practice address

7339 El Cajon Blvd
Suite I
La Mesa, CA 91941-3435

Phone

(619) 698-0606

Fax

(619) 698-0609

NPI assigned

May 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512086400000",
    "number": "1467401042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7339 EL CAJON BLVD",
            "address_2": "SUITE I",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919413435",
            "telephone_number": "619-698-0606",
            "fax_number": "619-698-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7339 EL CAJON BLVD",
            "address_2": "SUITE I",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919413435",
            "telephone_number": "619-698-0606",
            "fax_number": "619-698-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABAKER",
        "first_name": "VENU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2017-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A42653",
            "primary": false
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "CA",
            "license": "A042653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lydia Rhee Poon
• Beverly Portillo, IMF
• Tania Portillo, MD
• Tom J Pousti, MD
• Sean Thomas Powell, M.D.
• Arudi L Prabhakar, M.D.
• Namratha Prabhu, M.D.
• Eric Stafford Prante, PT
• Prasad Gonavarum D.D.S., Professional Corporation
• Allyson M Prather, MFT

• Adolescent Medicine (Internal Medicine) Physician in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Adolescent Medicine (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; 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.