Healthcare Provider Details

I. General information

NPI: 1891844759
Provider Name (Legal Business Name): VARSHA PURI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3945 WHITTIER BLVD
LOS ANGELES CA
90023-2440
US

IV. Provider business mailing address

505 N FIGUEROA ST APT 633
LOS ANGELES CA
90012-1599
US

V. Phone/Fax

Practice location:
  • Phone: 323-265-1998
  • Fax: 323-265-1998
Mailing address:
  • Phone: 949-683-6916
  • Fax: 949-683-6916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20A9142
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: