Provider Demographics
NPI:1487098497
Name:BELLA, ARCHIE PALIS (MD)
Entity type:Individual
Prefix:
First Name:ARCHIE
Middle Name:PALIS
Last Name:BELLA
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 1:1428 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-4624
Mailing Address - Country:US
Mailing Address - Phone:844-200-2426
Mailing Address - Fax:619-356-2726
Practice Address - Street 1:1428 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-4624
Practice Address - Country:US
Practice Address - Phone:844-200-2426
Practice Address - Fax:619-356-2726
Is Sole Proprietor?:No
Enumeration Date:2013-04-20
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA134155207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA134155OtherCA LICENSE
CAA134155OtherCA LICENSE