Provider Demographics
NPI:1215041397
Name:VARU, PARESH N (MD)
Entity Type:Individual
Prefix:DR
First Name:PARESH
Middle Name:N
Last Name:VARU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N FIRST ST
Mailing Address - Street 2:# A
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1803
Mailing Address - Country:US
Mailing Address - Phone:818-846-5888
Mailing Address - Fax:
Practice Address - Street 1:201 N FIRST ST
Practice Address - Street 2:STE A
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1803
Practice Address - Country:US
Practice Address - Phone:818-846-5888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65071207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A650710Medicaid
CAW15936Medicare ID - Type Unspecified
CA00A650710Medicaid