Provider Type Icon

SUDATHI JEEREDDI MD NPI 1609844984


NPI Information

NPI: 1609844984
Provider Name: SUDATHI JEEREDDI, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
790 EAST BONITA AVE
2ND FLOOR
POMONA, CA
ZIP 91767
Phone: (909) 447-8585
Get Directions

Sudathi Jeereddi, MD is a family medicine in Pomona, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Sudathi Jeereddi, MD NPI is 1609844984. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

790 EAST BONITA AVE
2ND FLOOR
POMONA, CA
ZIP 91767-906
Phone: (909) 447-8585
Fax: (909) 447-8593

The enumeration date for this NPI number is 3/10/2006 and was last updated on 5/6/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineA32264CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1WA32264GMEDICARE PINCALIFORNIA
2WA32264AMEDICARE PINCALIFORNIA
300A322641MEDICARE PINCALIFORNIA
4080159558MEDICARE PINCALIFORNIA
5B50194MEDICARE UPINCALIFORNIA
600A322640MEDICAIDCALIFORNIA
7080041661MEDICARE PINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.