Basic Information
| Provider Information | |||||||||
| NPI: | 1376102152 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HARISH YALAMANCHILI MD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23986 ALISO CREEK RD # 212 | ||||||||
| Address2: | |||||||||
| City: | LAGUNA NIGUEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926773908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9497180905 | ||||||||
| FaxNumber: | 9492090486 | ||||||||
| Practice Location | |||||||||
| Address1: | 2121 E COAST HWY # 150 | ||||||||
| Address2: | |||||||||
| City: | CORONA DEL MAR | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926251931 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9497180905 | ||||||||
| FaxNumber: | 9492090486 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2019 | ||||||||
| LastUpdateDate: | 12/14/2021 | ||||||||
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| AuthorizedOfficialLastName: | YALAMANCHILI | ||||||||
| AuthorizedOfficialFirstName: | HARISH | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8882583326 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 12/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 208600000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.