Provider Demographics
NPI:1639286495
Name:KORE, ARPUTHARAJ HIGGINS (MD)
Entity type:Individual
Prefix:
First Name:ARPUTHARAJ
Middle Name:HIGGINS
Last Name:KORE
Suffix:
Gender:M
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 670
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373
Mailing Address - Country:US
Mailing Address - Phone:909-777-3397
Mailing Address - Fax:909-777-3395
Practice Address - Street 1:197 EAST CAROLINE STREET
Practice Address - Street 2:SUITE 1400
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3729
Practice Address - Country:US
Practice Address - Phone:909-558-3636
Practice Address - Fax:909-558-3722
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00AS18240208600000X, 2086S0129X, 204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0079700Medicaid
CAGR0079700Medicaid
F64955Medicare UPIN