MEDICARE: PULAKANTI MD CORPORATION

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	207R00000X	Internal Medicine Physician	A51071	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902976376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PULAKANTI MD CORPORATION

Provider Business Mailing Address
First Line	:	7349 MILLIKEN AVE
Second Line	:	SUITE 104.306
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-7435
Country	:	US
Telephone Number	:	877-243-7790
Fax Number	:

Provider Business Practice Location Address
First Line	:	7349 MILLIKEN AVE
Second Line	:	SUITE 104.306
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-7435
Country	:	US
Telephone Number	:	877-243-7790
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR
Name	:	VENKATA S.R. PULAKANTI
Credential	:	M.D
Telephone Number	:	909-496-1195

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	01/26/2026

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Directions to “PULAKANTI MD CORPORATION ” Practice Location

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