Provider Demographics
NPI:1962460097
Name:MAHALINGAM, JAYAREENA (MD)
Entity Type:Individual
Prefix:DR
First Name:JAYAREENA
Middle Name:
Last Name:MAHALINGAM
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:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85366-2318
Mailing Address - Country:US
Mailing Address - Phone:928-317-9100
Mailing Address - Fax:
Practice Address - Street 1:50 E HUNTINGTON DR STE 200
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3209
Practice Address - Country:US
Practice Address - Phone:626-254-2293
Practice Address - Fax:626-254-8220
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ37589207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ491071Medicaid
Z137953Medicare PIN