Individual
APPANNAGARI GNANADEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 N PEPPER AVE, ARMC MODULAR # 3, COLTON, CA 92324-1801
(909) 580-6210
(909) 580-1363
Mailing address
PO BOX 670, REDLANDS, CA 92373
(909) 580-6210
(909) 580-1363
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
00A357430
CA
2086S0102X
Surgical Critical Care Physician
00A357430
CA
2086S0129X
Vascular Surgery Physician
00A357430
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0079700
—
CA
Enumeration date
08/25/2006
Last updated
09/30/2008
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