Provider Demographics
NPI:1477880102
Name:GARIMELLA, PRANAV SANDILYA (MD)
Entity Type:Individual
Prefix:DR
First Name:PRANAV
Middle Name:SANDILYA
Last Name:GARIMELLA
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9452 MEDICAL CENTER DR # MC7424
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1337
Mailing Address - Country:US
Mailing Address - Phone:582-463-2948
Mailing Address - Fax:585-527-5498
Practice Address - Street 1:9452 MEDICAL CENTER DR # MC7424
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1337
Practice Address - Country:US
Practice Address - Phone:617-636-8425
Practice Address - Fax:617-636-8329
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-17
Last Update Date:2020-04-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA143549207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology