MEDICARE: ARUDI PRABHAKAR MD APC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1265138101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARUDI PRABHAKAR MD APC

Provider Business Mailing Address
First Line	:	16848 SILVER CREST DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92127-2814
Country	:	US
Telephone Number	:	949-241-7154
Fax Number	:

Provider Business Practice Location Address
First Line	:	16848 SILVER CREST DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92127-2814
Country	:	US
Telephone Number	:	949-241-7154
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ARUDI PRABHAKAR
Credential	:	MD
Telephone Number	:	949-241-7154

Provider Enumeration Date	:	02/02/2023
Last Update Date	:	05/17/2023

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