Individual
PALGUNA THALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1227 E RUSHOLME ST, DAVENPORT, IA 52803-2459
(510) 250-0843
Mailing address
1601 CUMMINS DR STE D, MODESTO, CA 95358-6411
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD-55165
IA
208D00000X
General Practice Physician
35.151612
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2022
Last updated
08/29/2025
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