# SUDANAGUNTA PERAIAH MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538350111
- **Authorized official:** DR. SUDANAGUNTA PERAIAH MD (MD/OWNER)
- **Authorized official phone:** (209) 826-5224

## Contact information

- **Practice address:** 600 W I ST, B, LOS BANOS, CA 93635-3460
- **Practice address phone:** (209) 826-5224
- **Practice address fax:** (209) 826-5226
- **Mailing address:** PO BOX 1408, LOS BANOS, CA 93635-1408
- **Mailing address phone:** (209) 826-5224
- **Mailing address fax:** (209) 826-5226

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A24549 | CA | Yes |

## Other

- **Enumeration date:** 08/07/2007
- **Last updated:** 11/14/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00A245490 | — | CA |