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Individual

DR. NARAYANA G MEMULA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1800 MEDICAL CENTER DR, SUITE 100, SAN BERNARDINO, CA 92411-1218
(909) 887-8800
(909) 887-5678
Mailing address
6770 BROWN LN, POPLAR BLUFF, MO 63901-8652
(573) 560-1008
(573) 560-1008

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
C52162
CA
2085R0203X
Therapeutic Radiology Physician
Primary
R8431
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R8431
MEDICALLICENSE
MO
Enumeration date
08/01/2006
Last updated
12/21/2021
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