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:
Health care specialties
| Specialty | Code | License # | 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 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 | 1487762647 | NPPES |
| California | Other | A108120 | STATE LICENSE |
| California | Other | CB971Z | STATE LICENSE |
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