Healthcare Provider Details

I. General information

NPI: 1427394410
Provider Name (Legal Business Name): ARUNA PALLAPATI, M.D. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2012
Last Update Date: 05/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8990 GARFIELD ST 11
RIVERSIDE CA
92503-3926
US

IV. Provider business mailing address

435 SELKIRK DR
CORONA CA
92881-0941
US

V. Phone/Fax

Practice location:
  • Phone: 951-665-8815
  • Fax:
Mailing address:
  • Phone: 951-665-8815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA98165
License Number StateCA

VIII. Authorized Official

Name: DR. ARUNA PALLAPATI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 951-665-8815