Provider Demographics
NPI:1730392887
Name:RANGAPPA, SUNIL (MD)
Entity type:Individual
Prefix:
First Name:SUNIL
Middle Name:
Last Name:RANGAPPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5104
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90209-5104
Mailing Address - Country:US
Mailing Address - Phone:818-305-5671
Mailing Address - Fax:818-305-5672
Practice Address - Street 1:10515 BALBOA BLVD STE 375
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-6369
Practice Address - Country:US
Practice Address - Phone:818-305-5671
Practice Address - Fax:818-305-5672
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA93249207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1730392887Medicaid