Provider Demographics
NPI:1043771413
Name:VALLURUPALLI, VIVEK RAM (MD)
Entity Type:Individual
Prefix:
First Name:VIVEK
Middle Name:RAM
Last Name:VALLURUPALLI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:210 SANTA MONICA BLVD APT 301
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2277
Mailing Address - Country:US
Mailing Address - Phone:636-675-2481
Mailing Address - Fax:650-498-6205
Practice Address - Street 1:2121 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2303
Practice Address - Country:US
Practice Address - Phone:310-829-5511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-28
Last Update Date:2023-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA182469207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology