Provider Demographics
NPI:1972809978
Name:ANDHAVARAPU & CABALUNA INC
Entity Type:Organization
Organization Name:ANDHAVARAPU & CABALUNA INC
Other - Org Name:KINGS PEDIATRICS MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GIRIDHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDHAVARAPU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-583-4505
Mailing Address - Street 1:296 W HAROLD GRISWOLD WAY
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-8310
Mailing Address - Country:US
Mailing Address - Phone:559-381-9051
Mailing Address - Fax:
Practice Address - Street 1:1524 W LACEY BLVD
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5965
Practice Address - Country:US
Practice Address - Phone:559-583-4505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-08
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102374208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty