Provider Demographics
NPI:1346310976
Name:YUMA PULMONARY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:YUMA PULMONARY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MALLAPPA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEELAPPA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-344-0810
Mailing Address - Street 1:PO BOX 6229
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85366-2510
Mailing Address - Country:US
Mailing Address - Phone:928-344-0810
Mailing Address - Fax:928-726-4186
Practice Address - Street 1:2281 W 24TH ST STE 7
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6197
Practice Address - Country:US
Practice Address - Phone:928-344-0810
Practice Address - Fax:928-726-4186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32314207RP1001X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ845076Medicaid
AZAZ0747000OtherBC
Z79186Medicare ID - Type Unspecified
F89598Medicare UPIN