Basic Information
| Provider Information | |||||||||
| NPI: | 1538111547 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARUN | ||||||||
| FirstName: | PARVATANENI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4712 E 2ND ST # 533 | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908035309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5623423001 | ||||||||
| FaxNumber: | 5623423001 | ||||||||
| Practice Location | |||||||||
| Address1: | 2776 PACIFIC AVE | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908062613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5625951911 | ||||||||
| FaxNumber: | 5625951911 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2006 | ||||||||
| LastUpdateDate: | 05/30/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | A30167 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | ZZZ77353Z | 05 | CA | MEDICAID |