Organization
PURE PULSE HEALTH PHYSICIAN ASSISTANT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIPALI P RADIA PA-C (CEO)
(714) 553-5100
Entity
Organization
Contact information
Practice address
802 MAGNOLIA AVE STE 102, CORONA, CA 92879-3124
(714) 455-9831
Mailing address
802 MAGNOLIA AVE STE 102, CORONA, CA 92879-3124
(714) 455-9831
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437812260
—
CA
Enumeration date
02/02/2024
Last updated
02/02/2024
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