Narayana G Memula, M.D.

Primary specialty

Therapeutic Radiology PhysicianTaxonomy code 2085R0203X

License

R8431 Issued in MO

Practice address

1800 Medical Center Dr
Suite 100
San Bernardino, CA 92411-1218

Phone

(909) 887-8800

Fax

(909) 887-5678

NPI assigned

Aug 1, 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

Other identifiers 2

Other names 1

• Dr. Narayana Goud Memula Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Narayana G Memula,MDPC

  • Therapeutic Radiology Physician
  • Poplar Bluff, MO
  • NPI 1972516672
  NPD (past) Authorized official
• Poplar Bluff Cancer & Radiation Specialist LLC

  • Therapeutic Radiology Physician
  • Poplar Bluff, MO
  • NPI 1104963354
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1568478238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6770 BROWN LN",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639018652",
            "telephone_number": "573-560-1008",
            "fax_number": "573-560-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MEDICAL CENTER DR",
            "address_2": "SUITE 100",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111218",
            "telephone_number": "909-887-8800",
            "fax_number": "909-887-5678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6770 Brown Ln",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639018652",
            "country_code": "US",
            "telephone_number": "573-560-1008",
            "fax_number": "573-560-1008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEMULA",
        "first_name": "NARAYANA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "C52162",
            "primary": false
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "MO",
            "license": "R8431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICALLICENSE",
            "identifier": "R8431",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "R8431",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NARAYANA",
            "last_name": "MEMULA",
            "middle_name": "GOUD",
            "prefix": "DR.",
            "credential": "M.B.B.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brenda Patricia Melgoza, M.S
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• David Earl Melvin
• Edward Menacho, PA
• Robert James Mendes, MA
• Celena Mendez, MS, AMFT
• Dianey Mary Mendez, LVN
• Ernie Mendez

• Therapeutic Radiology Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Therapeutic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.