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Individual

BALA P ANNADURAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2147 MOWRY AVE, SUITE D4, FREMONT, CA 94538-1724
(510) 574-0800
(510) 574-0850
Mailing address
2147 MOWRY AVE, SUITE D4, FREMONT, CA 94538-1724
(510) 574-0800
(510) 574-0850

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A056197
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A561970
CA
01
P00145281
RAILROAD MEDICARE
Enumeration date
11/02/2005
Last updated
07/15/2013
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