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Individual

BHUPAL KOMMINENI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD FACP

Contact information

Practice address
1330 SAN BERNARDINO ROAD, SUITE G, UPLAND, CA 91786-4974
(909) 981-0989
(909) 949-6214
Mailing address
1330 SAN BERNARDINO ROAD, SUITE G, UPLAND, CA 91786-4974
(909) 981-0989
(909) 949-6214

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00A346510
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A346510
CA
01
953729807
TAX ID
CA
Enumeration date
02/08/2006
Last updated
08/01/2011
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