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1407807100
MOHAN ETTYREDDY
PORTERVILLE, CA
NPI
1407807100
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207L00000X Anesthesiology
(Licence: CA A82879)
Enumeration Date
2006-05-15
Last Update Date
2007-07-08
Business Address
Mr. MOHAN ETTYREDDY MD
465 W PUTNAM
PORTERVILLE, CA 93257
Phone number: 559-784-1110
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Mailing Address
Mr. MOHAN ETTYREDDY MD
PO BOX 7096
STOCKTON, CA 95267
Phone number: 209-956-7725
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