Organization
SRI MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SREEKANTH GANAPAVARAPU M.D. (PRESIDENT)
(909) 229-7500
Entity
Organization
Contact information
Practice address
18564 HIGHWAY 18, SUITE# 105, APPLE VALLEY, CA 92307-2312
(760) 242-7777
(909) 563-8447
Mailing address
8383 SVL BOX, VICTORVILLE, CA 92395-5168
(909) 229-7500
(909) 563-8447
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
A82967
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
082967
—
CA
Enumeration date
01/08/2008
Last updated
12/03/2012
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