Basic Information
| Provider Information | |||||||||
| NPI: | 1659526317 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | J VEMULAPALLI MD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 751 W LEGION RD | ||||||||
| Address2: | 201 | ||||||||
| City: | BRAWLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922277732 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 751 W LEGION RD | ||||||||
| Address2: | 201 | ||||||||
| City: | BRAWLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922277732 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603447976 | ||||||||
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| ProviderEnumerationDate: | 11/22/2008 | ||||||||
| LastUpdateDate: | 11/22/2008 | ||||||||
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| AuthorizedOfficialLastName: | VEMULAPALLI | ||||||||
| AuthorizedOfficialFirstName: | JAGANMOHAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4197895419 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | C52973 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Urology |
No ID Information.