Provider Demographics
NPI:1922057256
Name:KARUNANANTHAN, RUTH MANJULA (MD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:MANJULA
Last Name:KARUNANANTHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500W WEST COVINA PKWY
Mailing Address - Street 2:STE 203
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-2703
Mailing Address - Country:US
Mailing Address - Phone:626-430-9993
Mailing Address - Fax:626-960-8621
Practice Address - Street 1:1500 W WEST COVINA PKWY
Practice Address - Street 2:STE 102
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2703
Practice Address - Country:US
Practice Address - Phone:626-263-7010
Practice Address - Fax:626-960-3634
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64387207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A368060Medicaid
CA00A368060Medicaid
CAWA64387CMedicare PIN
CAH01321Medicare UPIN