Provider Demographics
NPI:1487739835
Name:ALLA, HARITHA R (MD)
Entity type:Individual
Prefix:
First Name:HARITHA
Middle Name:R
Last Name:ALLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HARITHA
Other - Middle Name:
Other - Last Name:BADDEVOLV
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MBBS
Mailing Address - Street 1:840 TOWNE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-5900
Mailing Address - Country:US
Mailing Address - Phone:909-398-1550
Mailing Address - Fax:909-398-1488
Practice Address - Street 1:8330 RED OAK ST STE 101
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-0603
Practice Address - Country:US
Practice Address - Phone:909-987-4922
Practice Address - Fax:909-466-1196
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC54107207R00000X, 207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADX251ZMedicare PIN