Basic Information
| Provider Information | |||||||||
| NPI: | 1255453171 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PILLUTLA | ||||||||
| FirstName: | PRIYA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | CENTER FOR THE HEALTH SCIENCES ROOM A2 237 | ||||||||
| Address2: | 650 CHARLES E. YOUNG DRIVE SOUTH | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900950001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108252019 | ||||||||
| FaxNumber: | 3108256346 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 MEDICAL PLZ | ||||||||
| Address2: | STE. 630 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900950001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108259011 | ||||||||
| FaxNumber: | 3108256346 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2007 | ||||||||
| LastUpdateDate: | 08/30/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A94291 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.