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General NPI Number Information
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NPI Number | 1215057187
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Entity Type | Organization
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Legal Business Name | GUNUPATI V CHELVAPILLA MD,MEDICAL CORPORATION
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 210 S GRAND AVE #207
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City | GLENDORA
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State | CA
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Zip | 91741-4205
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Country | US
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Telephone | 626-914-7000
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Fax | 626-914-7001
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Provider Business Mailing Address
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Address Line | 210 S GRAND AVE #207
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City | GLENDORA
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State | CA
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Zip | 91741-4205
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Country | US
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Telephone | 626-914-7000
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Fax | 626-914-7001
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHELVAPILLA VENKATA CHELVAPILLA
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Credential | M.D
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Telephone | 626-914-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A26608
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License Number State | CA
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