| NPI | 1073243655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRASAD JEEREDDI Director 909-398-1550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine |
| 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology | |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| 207RI0011X Internal Medicine, Interventional Cardiology | |
| 207RS0012X Internal Medicine, Sleep Medicine | |
| 207UN0901X Nuclear Medicine, Nuclear Cardiology | |
| 225B00000X Pulmonary Function Technologist | |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2023-06-09 |