Healthcare Provider Details

I. General information

NPI: 1750564779
Provider Name (Legal Business Name): ARUNA PALLAPATI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2007
Last Update Date: 02/03/2016
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

160 W FOOTHILL PKWY 105-245
CORONA CA
92882-8545
US

V. Phone/Fax

Practice location:
  • Phone: 951-665-8815
  • Fax: 866-512-8012
Mailing address:
  • Phone:
  • 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:
Title or Position:
Credential:
Phone: