Organization
INFECTIOUS DISEASE DOCTORS OF NEVADA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUDHAKAR V. MALLELA M.D. (PRESIDENT)
(702) 878-3235
Entity
Organization
Contact information
Practice address
4445 MAGNOLIA AVE, RIVERSIDE, CA 92501-4135
(951) 788-3000
Mailing address
3022 S DURANGO DR, SUITE 100, LAS VEGAS, NV 89117-4439
(702) 256-3637
(702) 256-3307
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
9640
NV
Other
Enumeration date
09/20/2006
Last updated
04/20/2016
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