Provider Demographics
NPI:1437285095
Name:NIRULA, ARVIND S (MD)
Entity Type:Individual
Prefix:DR
First Name:ARVIND
Middle Name:S
Last Name:NIRULA
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 1:18111 BROOKHURST ST # 5100
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-6728
Mailing Address - Country:US
Mailing Address - Phone:714-546-2238
Mailing Address - Fax:714-434-8145
Practice Address - Street 1:18111 BROOKHURST ST # 5100
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-6728
Practice Address - Country:US
Practice Address - Phone:714-546-2238
Practice Address - Fax:714-434-8145
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG83998207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAYYY492984YMedicaid
CAW5045OtherMEDICARE ID
CAWG83998CMedicare PIN
CAWG83998DMedicare PIN
CAH49045Medicare UPIN
CAYYY492984YMedicaid