Provider Demographics
NPI:1386931483
Name:KALPAGE, PALITHA VISHWAJITH (MD)
Entity type:Individual
Prefix:
First Name:PALITHA
Middle Name:VISHWAJITH
Last Name:KALPAGE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3189 W TUMAMOC DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-5266
Mailing Address - Country:US
Mailing Address - Phone:520-235-0597
Mailing Address - Fax:
Practice Address - Street 1:839 W CONGRESS STREES
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-6204
Practice Address - Country:US
Practice Address - Phone:520-670-3909
Practice Address - Fax:520-309-2560
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-09
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4887207Q00000X
AZR72791207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine