Provider Demographics
NPI:1447346002
Name:RAJU, THIRUMALA (MD)
Entity type:Individual
Prefix:
First Name:THIRUMALA
Middle Name:
Last Name:RAJU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:THIRUMALA
Other - Middle Name:
Other - Last Name:YENUMULAPALLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:2020 GENESEE AVE
Mailing Address - Street 2:2ND FLR
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123
Mailing Address - Country:US
Mailing Address - Phone:858-499-2600
Mailing Address - Fax:
Practice Address - Street 1:959 E WALNUT ST
Practice Address - Street 2:SUITE 120
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1451
Practice Address - Country:US
Practice Address - Phone:626-795-5118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75215207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A752150Medicare PIN