Provider Demographics
NPI:1063437648
Name:VENUTURUPALLI, R SWAMY (MD)
Entity type:Individual
Prefix:
First Name:R SWAMY
Middle Name:
Last Name:VENUTURUPALLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:R
Other - Middle Name:SWAMY
Other - Last Name:VENUTURUPALLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8750 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2703
Mailing Address - Country:US
Mailing Address - Phone:310-652-6010
Mailing Address - Fax:310-652-6056
Practice Address - Street 1:8750 WILSHIRE BLVD
Practice Address - Street 2:SUITE 350
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2703
Practice Address - Country:US
Practice Address - Phone:310-652-0010
Practice Address - Fax:310-652-6056
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69893207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A698930OtherBLUE SHIELD
CA00A698930Medicaid
CAWA69893BMedicare PIN
CA00A698930Medicaid