Organization
SOUTHLAND GI MEDICAL CORPORATION A PROFESSIONAL CORPORATION
Active
Organization
SOUTHLAND GI MEDICAL CORPORATION A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SREENIVASA RAO NAKKA M.D (PRESIDENT)
(951) 929-1177
Entity
Organization
Contact information
Practice address
25485 MEDICAL CENTER DR, STE 104, MURRIETA, CA 92562-6927
(951) 304-3900
(951) 304-3901
Mailing address
949 CALHOUN PL, STE A, HEMET, CA 92543-4403
(951) 929-1177
(951) 765-9111
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
08/26/2008
Last updated
06/29/2009
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