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NPI Code Detail

MEDICARE: DR. PADMINI VARADARAJAN M.D.

MEDICARE: DR. PADMINI VARADARAJAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease PhysicianA67664CA
2207RA0002XAdult Congenital Heart Disease Physician67664CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A67664OTHERCALICENSE

General Provider Information

NPI Number : 1255379301
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PADMINI VARADARAJAN M.D.
Provider Business Mailing Address
First Line : 1752 E LUGONIA AVE STE 117-1124
Second Line :
City : REDLANDS
State : CA
Zip : 92374-2730
Country : US
Telephone Number : 909-496-8653
Fax Number :
Provider Business Practice Location Address
First Line : 350 TERRACINA BLVD
Second Line :
City : REDLANDS
State : CA
Zip : 92373-4850
Country : US
Telephone Number : 909-335-5500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2006
Last Update Date : 04/04/2024

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