Healthcare Provider Details

I. General information

NPI: 1174742951
Provider Name (Legal Business Name): VINUTHA RAJESH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11234 ANDERSON ST SPC 1637
LOMA LINDA CA
92354-2804
US

IV. Provider business mailing address

11234 ANDERSON ST SPC 1637
LOMA LINDA CA
92354-2804
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-4756
  • Fax:
Mailing address:
  • Phone: 909-558-4756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number50678
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA120258
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number242393
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number242393
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: