Individual
PRAVEEN BUDDIGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7105 N CHESTNUT AVE STE 103, FRESNO, CA 93720-0357
(559) 421-9009
(559) 922-2422
Mailing address
PO BOX 26270, FRESNO, CA 93729-6270
(559) 421-9009
(559) 922-2422
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
A90273
CA
207R00000X
Internal Medicine Physician
A90273
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598703480
—
CA
01
—
CA115989
MEDICARE PTAN
—
01
—
CA115990
MEDICARE PTAN
CA
05
—
GR0043790
—
CA
Enumeration date
06/03/2006
Last updated
12/15/2016
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