Organization
CAJON MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANDITA PUCHAKAYALA MD (CEO)
(909) 941-4870
Entity
Organization
Contact information
Practice address
1738 N WATERMAN AVE STE 7&8, SAN BERNARDINO, CA 92404-5131
(909) 882-1269
(909) 882-5699
Mailing address
1809 W REDLANDS BLVD, REDLANDS, CA 92373-8054
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
01/25/2021
Last updated
01/25/2021
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