Provider Demographics
NPI:1174528178
Name:AMBATI, NARAYANA SRIMAN (MD)
Entity type:Individual
Prefix:DR
First Name:NARAYANA
Middle Name:SRIMAN
Last Name:AMBATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7014 N WHITNEY AVE
Mailing Address - Street 2:STE A
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0155
Mailing Address - Country:US
Mailing Address - Phone:559-321-2858
Mailing Address - Fax:559-321-2780
Practice Address - Street 1:7014 N WHITNEY AVE
Practice Address - Street 2:STE A
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0155
Practice Address - Country:US
Practice Address - Phone:559-321-2858
Practice Address - Fax:559-321-2780
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC416810208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C416810Medicaid
CA00C416811Medicare PIN
CAA89121Medicare UPIN