Provider Demographics
NPI:1194987263
Name:PILLAI, PROMOD (MD)
Entity type:Individual
Prefix:
First Name:PROMOD
Middle Name:
Last Name:PILLAI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:RAMACHANDRAN PILLAI
Other - Middle Name:
Other - Last Name:PROMOD KUMAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:25455 BARTON RD SUITE A 108
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354
Mailing Address - Country:US
Mailing Address - Phone:909-558-6388
Mailing Address - Fax:909-558-6309
Practice Address - Street 1:25455 BARTON RD STE 108A
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3139
Practice Address - Country:US
Practice Address - Phone:909-558-6388
Practice Address - Fax:909-558-4825
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.014461207T00000X
CAA137836207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery