Ettyreddy, Mohan

Ettyreddy, Mohan is an individual health care provider with primary practice located at 465 W Putnam , Porterville CA 93257. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Ettyreddy, Mohan can be contacted via phone (559) 784-1110.

Contact Information

Primary practice address
465 W Putnam Porterville CA 93257
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X A82879 California

Profile Details

NPI number 1407807100
LBN Legal business name Ettyreddy, Mohan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2006
Last updated Jul 8th, 2007 - about 19 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 1407807100 NPPES
California Other 00A828790 BS OF CA
California MEDICAID 00A828790 BS OF CA

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