Individual
SRIRAM SAMBASIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
180 NORTHPOINT DR, REDDING, CA 96003-2510
(530) 232-3000
(530) 242-8545
Mailing address
PO BOX 496084, REDDING, CA 96049-6084
(530) 232-3000
(530) 242-8545
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
A75554
CA
207RN0300X
Nephrology Physician
A75554
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A755540
—
CA
Enumeration date
08/05/2006
Last updated
03/30/2012
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