| Dr Marupuru A Professional Corporation | |
|
490 S Farrell Dr Ste C106 Palm Springs CA 92262-7962 | |
| (760) 416-6773 | |
| Not Available |
| Full Name | Dr Marupuru A Professional Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 490 S Farrell Dr Ste C106, Palm Springs, California |
| Authorized Official Name and Position | Soujanya Marupuru (PRESIDENT) |
| Authorized Official Contact | 3168416306 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Marupuru A Professional Corporation 73622 Vermeer Way Palm Desert CA 92211-4542 Ph: (785) 418-0314 | Dr Marupuru A Professional Corporation 490 S Farrell Dr Ste C106 Palm Springs CA 92262-7962 Ph: (760) 416-6773 |
| NPI Number | 1174090021 |
|---|---|
| Provider Enumeration Date | 10/30/2018 |
| Last Update Date | 11/12/2020 |
| Medicare PECOS PAC ID | 4789924135 |
|---|---|
| Medicare Enrollment ID | O20190320003419 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174090021 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Soujanya Marupuru |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740256460 PECOS PAC ID: 6204801830 Enrollment ID: I20100315000741 |
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