=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952569063
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MURALIKRISHNAN PARTHASARATHY M.D
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/26/2008
-----------------------------------------------------
Last Update Date | 01/15/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2120 THIBODO RD STE# 230
-----------------------------------------------------
City | VISTA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92081-7901
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-279-1223
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2579 OLD QUARRY RD APT # 2316
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92108-2786
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-955-6332
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | A105423
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------