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Organization
SUDESH NAGAVALLI MD INC.
Active
Organization
SUDESH NAGAVALLI MD INC.
Active
Other names
SUDESH NAGAVALLI MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUDESH NAGAVALLI MD (CEO)
(559) 583-4503
Entity
Organization
Contact information
Practice address
1524 W LACEY BLVD, SUITE 103, HANFORD, CA 93230-5965
(559) 583-4503
(559) 583-4600
Mailing address
PO BOX 480, HANFORD, CA 93232-0480
(559) 587-4349
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A53077
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A530770
—
CA
Enumeration date
04/14/2009
Last updated
09/16/2009
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