| NPI | 1235695289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRASAD A JEEREDDI President 909-398-1550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2019-03-04 |