Provider Demographics
NPI:1629019039
Name:VASUDEVA, ARUN KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ARUN
Middle Name:KUMAR
Last Name:VASUDEVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:731 E YOSEMITE AVE
Mailing Address - Street 2:STE. B, #411
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-8039
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9260 LAGUNA SPRINGS DR
Practice Address - Street 2:SUITE 302
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-7947
Practice Address - Country:US
Practice Address - Phone:916-216-4743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50493207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A504931Medicaid
AO405ZMedicare PIN
CA00A504931Medicaid