Provider Demographics
NPI:1629216742
Name:VIMI KAPUR M D ANESTH ESIOLOGIST INC A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:VIMI KAPUR M D ANESTH ESIOLOGIST INC A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIMI
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-677-3010
Mailing Address - Street 1:25470 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-4900
Mailing Address - Country:US
Mailing Address - Phone:951-677-3010
Mailing Address - Fax:951-677-3168
Practice Address - Street 1:25500 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5965
Practice Address - Country:US
Practice Address - Phone:951-677-3010
Practice Address - Fax:951-677-3168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-27
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA105170207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA105170OtherSTATE