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NPI Code Detail

MEDICARE: KAMALA VALLABHANENI M.D.

MEDICARE: KAMALA VALLABHANENI 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
1208000000XPediatrics Physician50704AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912134305
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAMALA VALLABHANENI M.D.
Provider Business Mailing Address
First Line : 7500 N DREAMY DRAW DR STE 145
Second Line :
City : PHOENIX
State : AZ
Zip : 85020-4668
Country : US
Telephone Number : 480-882-4545
Fax Number : 602-409-0499
Provider Business Practice Location Address
First Line : 8705 E MCDOWELL RD
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85257-3909
Country : US
Telephone Number : 480-882-4545
Fax Number : 480-405-8929
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2009
Last Update Date : 10/20/2023

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Directions to “ KAMALA VALLABHANENI M.D.” Practice Location

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