Healthcare Provider Details

I. General information

NPI: 1710122676
Provider Name (Legal Business Name): ANITHA R GARLAPATI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2008
Last Update Date: 08/12/2020
Certification Date: 08/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 GROSSMONT CENTER DR
LA MESA CA
91942-3019
US

IV. Provider business mailing address

13567 CALDERON RD
SAN DIEGO CA
92129-4413
US

V. Phone/Fax

Practice location:
  • Phone: 619-425-2737
  • Fax: 619-425-5869
Mailing address:
  • Phone: 858-342-2125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA83701
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberA83701
License Number StateCA

VIII. Authorized Official

Name: BHARAVI GARLAPATI
Title or Position: OFFICE MANAGER
Credential:
Phone: 858-342-2125