Individual
AVANTIKA RUDRARAJU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 E ORANGEBURG AVE, MODESTO, CA 95350-5355
(209) 522-8881
Mailing address
201 E ORANGEBURG AVE, MODESTO, CA 95350-5355
(209) 522-8881
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
10581A
WY
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
A177500
CA
Other
Enumeration date
07/10/2013
Last updated
04/18/2024
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