Provider Demographics
NPI:1366671786
Name:MEDWIN A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MEDWIN A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RADHIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:TULPULE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-338-1155
Mailing Address - Street 1:910 SOUTH SUNSET AVE. SUITE 7 & 8
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790
Mailing Address - Country:US
Mailing Address - Phone:626-338-1155
Mailing Address - Fax:626-338-1125
Practice Address - Street 1:910 S SUNSET AVE STE 7&8
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3409
Practice Address - Country:US
Practice Address - Phone:626-338-1155
Practice Address - Fax:626-338-1125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-07
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty