Basic Information
Provider Information
NPI: 1154693786
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAVIPURAPU
FirstName: KIRAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5767 W CENTURY BLVD STE 400
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900455631
CountryCode: US
TelephoneNumber: 3103018707
FaxNumber:  
Practice Location
Address1: 200 UCLA MEDICAL PLZ STE 430
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900953315
CountryCode: US
TelephoneNumber: 3107947274
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/27/2012
LastUpdateDate: 08/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X390200000CAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


Home