Provider Demographics
NPI:1124358452
Name:VERMANI MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:VERMANI MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAWAN
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:VERMANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-966-1113
Mailing Address - Street 1:530 W BADILLO ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-3787
Mailing Address - Country:US
Mailing Address - Phone:626-966-1113
Mailing Address - Fax:626-967-2700
Practice Address - Street 1:530 W BADILLO ST
Practice Address - Street 2:SUITE B
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722
Practice Address - Country:US
Practice Address - Phone:626-966-1113
Practice Address - Fax:626-967-2700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62331302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0050434Medicaid
CA0050434Medicaid
CAA62331Medicare PIN