Organization
HEALTHY KIDS PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRASHANTH PORAYETTE MD (CHIEF EXECUTIVE OFFICER)
(317) 709-4701
Entity
Organization
Contact information
Practice address
9481 PITTSBURGH AVE STE 200, RANCHO CUCAMONGA, CA 91730-9021
(909) 655-0300
Mailing address
9481 PITTSBURGH AVE STE 200, RANCHO CUCAMONGA, CA 91730-9021
(909) 655-0300
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
—
—
Other
Enumeration date
02/18/2025
Last updated
02/18/2025
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