Provider Demographics
NPI:1467605709
Name:YOGESH K PALIWAL MD INC
Entity Type:Organization
Organization Name:YOGESH K PALIWAL MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YOGESH
Authorized Official - Middle Name:K
Authorized Official - Last Name:PALIWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-623-2300
Mailing Address - Street 1:1818 N ORANGE GROVE AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-3028
Mailing Address - Country:US
Mailing Address - Phone:909-623-2300
Mailing Address - Fax:
Practice Address - Street 1:1818 N ORANGE GROVE AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3028
Practice Address - Country:US
Practice Address - Phone:909-623-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35011207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A35011Medicaid
CA00A35011Medicaid