MEDICARE: BHAVYA VENIGALLA

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
1	207L00000X	Anesthesiology Physician	MD-54889	IA
2	207L00000X	Anesthesiology Physician	A206018	CA

General Provider Information

NPI Number	:	1861021644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BHAVYA VENIGALLA

Provider Business Mailing Address
First Line	:	200 HAWKINS DR
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52242-1009
Country	:	US
Telephone Number	:	319-356-2633
Fax Number	:	319-356-2940

Provider Business Practice Location Address
First Line	:	8700 BEVERLY BLVD # SB-290
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90048-1804
Country	:	US
Telephone Number	:	310-423-5841
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2020
Last Update Date	:	04/17/2026

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Directions to “ BHAVYA VENIGALLA ” Practice Location

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