Individual
JAYAKALA LAKIREDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4601 DALE RD, MODESTO, CA 95356-9718
(209) 735-5000
Mailing address
500 W HOSPITAL RD, FRENCH CAMP, CA 95231-9693
(209) 468-6000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20383
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2019
Last updated
10/17/2024
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