Jeereddi, Sudathi
Jeereddi, Sudathi is an individual health care provider with primary practice located at 790 East Bonita Ave 2Nd Floor, Pomona CA 91767-1906. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Jeereddi, Sudathi can be contacted via phone (909) 447-8585.Contact Information
Primary practice address
790 East Bonita Ave 2Nd Floor
Pomona CA 91767-1906
Phone: (909) 447-8585
Fax: (909) 447-8593
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | A32264 | California |
Profile Details
| NPI number | 1609844984 |
|---|---|
| LBN Legal business name | Jeereddi, Sudathi |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 10th, 2006 |
| Last updated | May 6th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609844984 | NPPES |
| California | MEDICAID | 00A322640 |
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