Basic Information
| Provider Information | |||||||||
| NPI: | 1578874186 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YALAMANCHILI | ||||||||
| FirstName: | HARISH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 840 TOWNE CENTER DR | ||||||||
| Address2: | |||||||||
| City: | POMONA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917675900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9093981550 | ||||||||
| FaxNumber: | 9093981488 | ||||||||
| Practice Location | |||||||||
| Address1: | 2121 E COAST HWY STE 150 | ||||||||
| Address2: | |||||||||
| City: | CORONA DEL MAR | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926251940 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9497180905 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2010 | ||||||||
| LastUpdateDate: | 12/14/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 35.120835 | OH | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | A140164 | CA | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.