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Organization
SYAM P VUNNAMADALA MEDICAL CORP
Active
Organization
SYAM P VUNNAMADALA MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYAM P VUNNAMADALA M.D (SOLE OWNER)
(714) 491-3928
Entity
Organization
Contact information
Practice address
1211 W LA PALMA AVE STE 310, ANAHEIM, CA 92801-2815
(714) 491-3928
(714) 491-3960
Mailing address
10 VIA GIADA, NEWPORT COAST, CA 92657-1623
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A64189
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A641890
—
CA
Enumeration date
03/16/2017
Last updated
06/13/2017
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