Provider Demographics
NPI:1902014574
Name:AMIRTHARAJAH, MOHANA (MD)
Entity Type:Individual
Prefix:
First Name:MOHANA
Middle Name:
Last Name:AMIRTHARAJAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 OWENS ST
Mailing Address - Street 2:UCSF ORTHOPAEDIC INSTITUTE
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-2332
Mailing Address - Country:US
Mailing Address - Phone:415-353-9400
Mailing Address - Fax:415-353-9643
Practice Address - Street 1:1500 OWENS ST
Practice Address - Street 2:UCSF ORTHOPAEDIC INSTITUTE
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-2332
Practice Address - Country:US
Practice Address - Phone:415-353-9400
Practice Address - Fax:415-353-9643
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAR-6850207X00000X
CAA105922207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery