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General NPI Number Information
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NPI Number | 1407952229
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Entity Type | Individual
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Provider Name | DR. AYYAMPALAYAM RAJU MOHAN
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Gender | Male
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1818 N ORANGE GROVE AVE SUITE 308
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City | POMONA
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State | CA
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Zip | 91767-3028
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Country | US
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Telephone | 909-622-6050
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Fax | 909-620-4632
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Provider Business Mailing Address
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Address Line | 1818 N ORANGE GROVE AVE SUITE 308
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City | POMONA
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State | CA
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Zip | 91767-3028
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Country | US
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Telephone | 909-622-6050
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Fax | 909-620-4632
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A37819
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | A37819
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License Number State | CA
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