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Individual

DR. DIVAKAR KRISHNAREDDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
16702 VALLEY VIEW AVE, LA MIRADA, CA 90638-5824
(562) 921-0341
(562) 404-0266
Mailing address
2680 SATURN AVE STE 210, HUNTINGTON PARK, CA 90255-4568
(323) 587-3965

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A35665
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A356650
CA
Enumeration date
06/17/2006
Last updated
07/21/2022
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