Healthcare Provider Details

I. General information

NPI: 1295002475
Provider Name (Legal Business Name): BAPI RAJU V KURADA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2011
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 E DEVONSHIRE AVE BLDG SUITE209
HEMET CA
92543-3083
US

IV. Provider business mailing address

33965 MILAT ST
TEMECULA CA
92592-5502
US

V. Phone/Fax

Practice location:
  • Phone: 951-765-4910
  • Fax:
Mailing address:
  • Phone: 858-354-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number63681
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: