Individual
SUDHAKAR V MALLELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6885 BROCKTON AVE, RIVERSIDE, CA 92506
(951) 468-1306
(951) 784-8934
Mailing address
6885 BROCKTON AVE, RIVERSIDE, CA 92506-3811
(951) 462-1306
(951) 784-8934
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
9640
NV
207R00000X
Internal Medicine Physician
C131483
CA
207RI0200X
Infectious Disease Physician
9640
NV
207RI0200X
Infectious Disease Physician
Primary
C131483
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002018743
—
NV
Enumeration date
09/20/2006
Last updated
03/15/2023
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