Praveen Reddy Kambam, M.D.

Primary specialty

Forensic Psychiatry PhysicianTaxonomy code 2084F0202X

License

A100457 Issued in CA

Practice address

11500 W Olympic Blvd
538
Los Angeles, CA 90064

Phone

(310) 231-8964

Fax

(310) 627-1657

NPI assigned

Feb 27, 2007

Last updated

Nov 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1912034141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "644 N FULLER AVE PMB 7190",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900361939",
            "telephone_number": "310-231-8964",
            "fax_number": "310-627-1657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 W OLYMPIC BLVD",
            "address_2": "538",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90064",
            "telephone_number": "310-231-8964",
            "fax_number": "310-627-1657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMBAM",
        "first_name": "PRAVEEN",
        "middle_name": "REDDY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A100457",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "CA",
            "license": "A100457",
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "CA",
            "license": "A100457",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A100457",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rabindra Ramanath Kamath, DDS
• Rahul Kamath
• Sunil P Kamath, MD
• Lucy Wangeci Kamau
• Stephen Kamau
• Kambiz D Abadi DMD Inc
• Kambiz Yazdi, DC, Inc
• Anjana V. Kamdar, M.D.
• Gopika Kamdar, M.A., CCC-SLP
• Monisha Rehana Kamdar, NP-C

• Forensic Psychiatry Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Forensic Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.