Provider Demographics
NPI:1174761308
Name:MOHAN RAO, MD, INC.
Entity type:Organization
Organization Name:MOHAN RAO, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-331-1560
Mailing Address - Street 1:114 S MARGUERITA AVE
Mailing Address - Street 2:#2
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3219
Mailing Address - Country:US
Mailing Address - Phone:626-331-1560
Mailing Address - Fax:
Practice Address - Street 1:114 S MARGUERITA AVE
Practice Address - Street 2:#2
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3219
Practice Address - Country:US
Practice Address - Phone:626-331-1560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-26
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 62446207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty