Individual provider Active NPI

Vijayasree Paruchuri, MD

  • Anesthesiology Physician
  • Yorba Linda, CA
National Provider Identifier
1790769578
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A69396 Issued in CA
Practice address
19055 Green Oaks Rd
Yorba Linda, CA 92886-2750
Phone
(714) 269-5755
Fax
(714) 763-4374
NPI assigned
Dec 5, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A69396 CA Primary

Addresses

Primary practice location

19055 Green Oaks Rd
Yorba Linda, CA 92886-2750

Mailing address

PO Box 640
Yorba Linda, CA 92885-0640
Phone (714) 269-5755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050511000139 CA Practitioner - Anesthesiology 7719927557 Reassigns benefits to 1 organization
Practice locations: La Mirada, CA; Upland, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A69396CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
KND Development 59, LLC CurrentSince Aug 12, 2017 Accepting new patients
KND Development 59 LLC CurrentSince Aug 12, 2017 Accepting new patients
KND Development 59 LLC Current Accepting new patients

Locations

5525 W Slauson Ave
Los Angeles, CA 90056
Phone (310) 642-0325

14900 Imperial Hwy
Mirada, CA 90638
Phone (559) 627-6363

10841 White Oak Ave
Rch Cucamonga, CA 91730
Phone (626) 914-1514

1901 College Ave
Santa Ana, CA 92706
Phone (714) 564-7800

845 N Lark Ellen Ave
West Covina, CA 91791
Phone (626) 339-5451

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1790769578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928850640",
            "telephone_number": "714-269-5755",
            "fax_number": "714-763-4374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19055 GREEN OAKS RD",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928862750",
            "telephone_number": "714-269-5755",
            "fax_number": "714-763-4374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARUCHURI",
        "first_name": "VIJAYASREE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A69396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorba Linda, CA

Sources for this page

Verify at the official NPI Registry.