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Individual

SRAVYA DASYAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
445 W EATON AVE, TRACY, CA 95376-3420
(209) 833-2367
(602) 294-5090
Mailing address
PO BOX 255228, SACRAMENTO, CA 95865-5228

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A148113
CA
208M00000X
Hospitalist Physician
Primary
A148113
CA
390200000X
Student in an Organized Health Care Education/Training Program
AZ

Other

Enumeration date
07/06/2014
Last updated
02/02/2021
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