Individual
PRAVEEN REDDY KAMBAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11500 W OLYMPIC BLVD, 538, LOS ANGELES, CA 90064
(310) 231-8964
(310) 627-1657
Mailing address
644 N FULLER AVE PMB 7190, LOS ANGELES, CA 90036-1939
(310) 231-8964
(310) 627-1657
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
A100457
CA
2084F0202X
Forensic Psychiatry Physician
Primary
A100457
CA
2084P0800X
Psychiatry Physician
A100457
CA
2084P0804X
Child & Adolescent Psychiatry Physician
A100457
CA
Other
Enumeration date
02/27/2007
Last updated
11/23/2020
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