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Organization
JANARDHANA R KOLAVALA A PROFESSIONAL CORPORATION
Active
Organization
JANARDHANA R KOLAVALA A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON HALL (OFFICE MANAGER)
(760) 242-3634
Entity
Organization
Contact information
Practice address
18523 CORWIN RD, SUITE E, APPLE VALLEY, CA 92307-2338
(760) 242-3634
Mailing address
18523 CORWIN RD, SUITE E, APPLE VALLEY, CA 92307-2338
(760) 242-3634
(760) 242-2119
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A38782
—
CA
01
—
290000417
RAILROAD MEDICARE
CA
Enumeration date
07/10/2007
Last updated
10/28/2008
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