Organization
SUDANAGUNTA PERAIAH MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUDANAGUNTA PERAIAH MD (MD/OWNER)
(209) 826-5224
Entity
Organization
Contact information
Practice address
600 W I ST, B, LOS BANOS, CA 93635-3460
(209) 826-5224
(209) 826-5226
Mailing address
PO BOX 1408, LOS BANOS, CA 93635-1408
(209) 826-5224
(209) 826-5226
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A24549
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A245490
—
CA
Enumeration date
08/07/2007
Last updated
11/14/2013
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