Individual
MR. SASANK PYMAGAM REDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
REGISTERED NURSE
Contact information
Practice address
500. S.VERMONT AVE, LOS ANGELES, CA 90020
(213) 485-3375
Mailing address
1263 OAK RIDGE DR, LA VERNE, CA 91750-1524
(909) 392-6877
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
521882
CA
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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