Healthcare Provider Details

I. General information

NPI: 1639286495
Provider Name (Legal Business Name): ARPUTHARAJ HIGGINS KORE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

197 EAST CAROLINE STREET SUITE 1400
SAN BERNARDINO CA
92408-3729
US

IV. Provider business mailing address

PO BOX 670
REDLANDS CA
92373
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-3636
  • Fax: 909-558-3722
Mailing address:
  • Phone: 909-777-3397
  • Fax: 909-777-3395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number00AS18240
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number00AS18240
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number00AS18240
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: