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:
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Health care specialties

SpecialtyCodeLicense #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 15 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 1609844984 NPPES
California MEDICAID 00A322640

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