Individual
DR. SUDHAKAR REDDIVALAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9300 VALLEY CHILDRENS PL, MADERA, CA 93638-8761
(559) 353-5550
(559) 353-5587
Mailing address
9300 VALLEY CHILDRENS PL, MADERA, CA 93638-8761
(559) 353-5550
(559) 353-5587
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
A49339
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A493390
INDIVIDUAL NUMBER
CA
05
—
GR0103350
—
CA
Enumeration date
01/19/2007
Last updated
07/09/2007
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