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General NPI Number Information
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NPI Number | 1255508123
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Entity Type | Individual
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Provider Name | VENKATA NAGA KIRAN DINTYALA MD
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Gender | Male
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Dates
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Enumeration Date | 05/09/2008
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 888 PROSPECT ST STE 223
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City | LA JOLLA
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State | CA
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Zip | 92037-4261
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Country | US
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Telephone | 858-869-0894
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Fax |
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Provider Business Mailing Address
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Address Line | 8088 GILMAN CT
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City | LA JOLLA
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State | CA
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Zip | 92037-2932
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Country | US
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Telephone | 760-567-6725
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | A131545
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A131545
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License Number State | CA
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