| Kalyan Dandala, Md Pllc | |
|
350 S 38th Ct Ste 100 Renton WA 98055-5777 | |
| (714) 828-1800 | |
| (714) 882-1186 |
| Full Name | Kalyan Dandala, Md Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Addiction Psychiatry |
| Location | 350 S 38th Ct Ste 100, Renton, Washington |
| Authorized Official Name and Position | Magdalen Gustilo (DIRECTOR OF PAYER RELATIONS) |
| Authorized Official Contact | 7145687667 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kalyan Dandala, Md Pllc 18401 Von Karman Ave Ste 500 Irvine CA 92612-8531 Ph: (714) 828-1800 | Kalyan Dandala, Md Pllc 350 S 38th Ct Ste 100 Renton WA 98055-5777 Ph: (714) 828-1800 |
| NPI Number | 1558600650 |
|---|---|
| Provider Enumeration Date | 02/08/2013 |
| Last Update Date | 05/08/2023 |
| Certification Date | 05/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558600650 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0802X | Psychiatry & Neurology - Addiction Psychiatry | MD00048010 (Washington) | Primary |
| 363LA2200X | Nurse Practitioner - Adult Health | AP30007637 (Washington) | Secondary |
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