Maddula, Mallareddy

Maddula, Mallareddy is an individual health care provider with primary practice located at 1801 E March Ln Suite B265, Stockton CA 95210-6629. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Maddula, Mallareddy can be contacted via phone (209) 546-1868.

Contact Information

Primary practice address
1801 E March Ln Suite B265 Stockton CA 95210-6629
Phone: (209) 546-1868
Fax: (209) 461-6505
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X ME96158 Florida
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X A108120 California

Profile Details

NPI number 1487762647
LBN Legal business name Maddula, Mallareddy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2006
Last updated Feb 28th, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487762647 NPPES
California Other A108120 STATE LICENSE
California Other CB971Z STATE LICENSE

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