Individual
DWARAKNATH PONNALUR REDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
811 E 11TH ST, SUITE 208, UPLAND, CA 91786-4871
(909) 629-5540
(909) 946-3070
Mailing address
811 E 11TH ST, SUITE 208, UPLAND, CA 91786-4871
(909) 629-5540
(909) 946-3070
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A34093
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A340931
—
CA
Enumeration date
08/01/2006
Last updated
07/08/2007
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