Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | A69893 | CA |
NPI | 1063437648 |
---|---|
Provider Name | R Swamy Venuturupalli |
First Address | Beverly Hills, CA 90211-2703 |
Second Address | Beverly Hills, CA 90211-2703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 13/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A698930 | (05) | CA |
00A698930 | BLUE SHIELD (01) | CA |
H71348 | (02) | CA |