Provider Demographics
NPI:1124465745
Name:RAJAGOPAL, AMUTHA V (M D)
Entity type:Individual
Prefix:
First Name:AMUTHA
Middle Name:V
Last Name:RAJAGOPAL
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3011
Mailing Address - Country:US
Mailing Address - Phone:503-494-5862
Mailing Address - Fax:503-494-6344
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-494-5862
Practice Address - Fax:503-494-6344
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2025-08-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD227060207RA0401X, 207RI0200X, 2083A0300X, 2083P0901X, 207R00000X
IL0.36.140481207RI0200X
CA135167207RI0200X
CAA1351672083A0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine