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General NPI Number Information
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NPI Number | 1801820857
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Entity Type | Organization
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Legal Business Name | BHARATHI S VAYUVEGULA MD PHD INC
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 1624 S GRAND AVE
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City | GLENDORA
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State | CA
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Zip | 91740-5433
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Country | US
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Telephone | 626-914-0174
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Fax | 626-914-2008
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Provider Business Mailing Address
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Address Line | 1624 S GRAND AVE
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City | GLENDORA
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State | CA
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Zip | 91740-5433
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Country | US
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Telephone | 626-914-0174
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Fax | 626-914-2008
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Authorized Official
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Title or Position | OWNER
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Name | DR. BHARATHI S VAYUVEGULA
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Credential | MD
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Telephone | 626-914-0174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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