Individual
PRASAD ANJANEYA JEEREDDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1904 N ORANGE GROVE AVE, POMONA, CA 91767-3008
(909) 469-1823
(909) 469-1827
Mailing address
840 TOWNE CENTER DR, POMONA, CA 91767-5900
(909) 398-1550
(909) 398-1488
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A32129
CA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
A32129
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A321290
—
CA
Enumeration date
03/27/2006
Last updated
09/13/2018
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