Organization
BHARATHI S VAYUVEGULA MD PHD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BHARATHI S VAYUVEGULA MD (OWNER)
(626) 914-0174
Entity
Organization
Contact information
Practice address
1624 S GRAND AVE, GLENDORA, CA 91740-5433
(626) 914-0174
(626) 914-2008
Mailing address
1624 S GRAND AVE, GLENDORA, CA 91740-5433
(626) 914-0174
(626) 914-2008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
W21346
—
CA
Enumeration date
07/10/2006
Last updated
01/05/2022
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