Individual
MR. GOVARDHANACHARY VADLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9025 COLORADO AVE, RIVERSIDE, CA 92503-2157
(951) 688-3636
Mailing address
818 ALLEGRE CIR, CORONA, CA 92879-8874
(917) 312-2090
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
16382
CA
Other
Enumeration date
02/09/2024
Last updated
02/09/2024
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