Reddy, Dwaraknath Ponnalur
Reddy, Dwaraknath Ponnalur is an sole proprietor health care provider with primary practice located at 811 E 11Th St Suite 208, Upland CA 91786-4871. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Reddy, Dwaraknath Ponnalur can be contacted via phone (909) 629-5540.Contact Information
Primary practice address
811 E 11Th St Suite 208
Upland CA 91786-4871
Phone: (909) 629-5540
Fax: (909) 946-3070
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | A34093 | California |
Profile Details
| NPI number | 1417964917 |
|---|---|
| LBN Legal business name | Reddy, Dwaraknath Ponnalur |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 1st, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1417964917 | NPPES |
| California | MEDICAID | 00A340931 |
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