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Organization
EPISOURCE LLC
Active
Organization
EPISOURCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SISHIR REDDY (CEO)
(714) 452-1962
Entity
Organization
Contact information
Practice address
500 W 190TH ST, 4TH FLOOR, GARDENA, CA 90248-4268
(714) 452-1961
(714) 452-1966
Mailing address
500 W 190TH ST, 4TH FLOOR, GARDENA, CA 90248-4268
(714) 452-1961
(714) 452-1966
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/14/2012
Last updated
02/07/2023
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