Provider Demographics
NPI:1871690529
Name:ML PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ML PROFESSIONAL CORPORATION
Other - Org Name:VERMA CLINIC INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:RAMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VERMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-713-1111
Mailing Address - Street 1:5128 W CYPRESS AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-8303
Mailing Address - Country:US
Mailing Address - Phone:559-713-1111
Mailing Address - Fax:559-713-1199
Practice Address - Street 1:5128 W CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-8303
Practice Address - Country:US
Practice Address - Phone:559-713-1111
Practice Address - Fax:559-713-1199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-17
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A680010174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A680010OtherSTATE
CAG75573Medicare UPIN