Individual
ARCHANA MALLELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4723 W MAIN ST STE H, GUADALUPE, CA 93434-1787
(805) 343-5577
Mailing address
4723 W MAIN ST STE H, GUADALUPE, CA 93434-1787
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A18525
CA
Other
Enumeration date
04/07/2017
Last updated
08/22/2024
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