# SOUTHERN CALIFORNIA INFECTIOUS DISEASE MEDICAL GROUP

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

## Provider details

- **NPI number:** 1639100662
- **Authorized official:** SUMAN RADHAKRISHNA MD (MD/PARTNER)
- **Authorized official phone:** (213) 483-0901

## Contact information

- **Practice address:** 2325 TOWNSGATE RD, SUITE 100, WESTLAKE VILLAGE, CA 91361-5986
- **Practice address phone:** (213) 483-0901
- **Practice address fax:** (213) 483-6650
- **Mailing address:** PO BOX 2190, LA HABRA, CA 90632-2190
- **Mailing address phone:** (213) 483-0901
- **Mailing address fax:** (213) 483-6650

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | W11997 | CA | Yes |

## Other

- **Enumeration date:** 07/06/2006
- **Last updated:** 12/04/2025