Organization
SIVA PRASAD MULLANGI MD A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIVA P MULLANGI MD (PRESIDENT)
(909) 912-4353
Entity
Organization
Contact information
Practice address
5365 WALNUT AVE STE I, CHINO, CA 91710
(909) 315-6399
(909) 315-6696
Mailing address
PO BOX 898, CHINO HILLS, CA 91709-0030
(909) 912-4353
(909) 626-8384
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A64112
CA
Other
Enumeration date
05/06/2013
Last updated
05/16/2018
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