Individual
DR. SASIDHARAN PONTHENKANDATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3390 UNIVERSITY AVE STE 100, RIVERSIDE, CA 92501-3315
(844) 827-8000
Mailing address
3390 UNIVERSITY AVE STE 100, RIVERSIDE, CA 92501-3315
(844) 827-8000
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
28183
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137-405-7
ECFMG
—
05
—
30783600
—
WI
01
—
559798
UHC
WI
Enumeration date
06/15/2007
Last updated
03/16/2026
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