Rajeev Lochan Panguluri, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

19890 Issued in MS

Practice address

624 E Elder St
Fallbrook, CA 92028-3004

Phone

(760) 451-4165

Fax

(858) 221-8554

NPI assigned

Jun 14, 2007

Sex

Male

Sole proprietor

Yes

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

State licenses

Practice roles

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

• Advocate North Side Health Network

  • Clinic/Center
  • Chicago, IL
  • NPI 1780788323
  NPD (past)

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638662400000",
    "number": "1467656181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15297 CAYENNE CREEK CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921273717",
            "telephone_number": "601-942-8419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 E ELDER ST",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283004",
            "telephone_number": "760-451-4165",
            "fax_number": "858-221-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANGULURI",
        "first_name": "RAJEEV",
        "middle_name": "LOCHAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2021-12-05",
        "certification_date": "2021-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C148863",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "19890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Pharmacy Group
• Adam Paul Padilla
• Aria Leigh Palmieri, LMT
• Palomar Family Counseling Service, Inc.
• Palomar Family Counseling Service, Inc.
• Nipa Manfredi Panyarit
• Paradise Residential Care Facilities for the Elderly
• Paragon Recovery LLC
• Grigoriy N Patish, DPM
• Crystal Pearce

• Psychiatry Physician in Fallbrook, CA
• Providers in Fallbrook, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2021; 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.