Provider Demographics
NPI:1053473934
Name:VELKURU, HYMAVATHI (MD)
Entity Type:Individual
Prefix:MRS
First Name:HYMAVATHI
Middle Name:
Last Name:VELKURU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W HUNTINGTON DR
Mailing Address - Street 2:SUITE #327
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-3462
Mailing Address - Country:US
Mailing Address - Phone:626-447-8138
Mailing Address - Fax:626-447-2094
Practice Address - Street 1:301 W HUNTINGTON DR
Practice Address - Street 2:SUITE #327
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-3462
Practice Address - Country:US
Practice Address - Phone:626-447-8138
Practice Address - Fax:626-447-2094
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31704208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A317040Medicaid
CAA26580Medicare UPIN