Praveena Yetur, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

A43640 Issued in CA

Practice address

250 S Grand Ave
Glendora, CA 91741-4218

Phone

(626) 857-3201

NPI assigned

Mar 22, 2006

Last updated

Aug 31, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• San Gabriel Valley Consulting Pathologists Medical Group, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • South El Monte, CA
  • NPI 1700845179

  Cytopathology

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1043279490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 E COLORADO BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911061721",
            "telephone_number": "626-584-0718",
            "fax_number": "626-584-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414218",
            "telephone_number": "626-857-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YETUR",
        "first_name": "PRAVEENA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-22",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "CA",
            "license": "A43640",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A43640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yolanda Yanez, PHARMD
• Steve Yang, NP
• Gloria Theresa Yee, M.D.
• Myrna Diaz Yepez
• Michael Yeranosian, M.D.
• Rosemary Yi, MD
• Yong S. Chen, M.D., Inc.
• Kenneth K York, M.D.
• Douglas James Yost, MA
• Anna L. Young

• Anatomic Pathology & Clinical Pathology Physician in Glendora, CA
• Providers in Glendora, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.