Banajjar Revanasiddappa, Vanitha

Banajjar Revanasiddappa, Vanitha is an individual health care provider with primary practice located at 797 W Childs Ave , Merced CA 95341-6805. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is her primary health care specialty. Banajjar Revanasiddappa, Vanitha can be contacted via phone (866) 682-4842.

Contact Information

Primary practice address
797 W Childs Ave Merced CA 95341-6805
Phone: (866) 682-4842
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X A162179 California

Profile Details

NPI number 1669856217
LBN Legal business name Banajjar Revanasiddappa, Vanitha
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2015
Last updated May 12th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669856217 NPPES
California MEDICAID 1669856217

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