Provider Demographics
NPI:1114227733
Name:NADIPALLY, SUDHAKAR (MBBS,MPH,MD)
Entity Type:Individual
Prefix:DR
First Name:SUDHAKAR
Middle Name:
Last Name:NADIPALLY
Suffix:
Gender:M
Credentials:MBBS,MPH,MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 S MADERA AVE
Mailing Address - Street 2:KERMAN HEALTH CENTER VALLEY HEALTH TEAM
Mailing Address - City:KERMAN
Mailing Address - State:CA
Mailing Address - Zip Code:93630-1537
Mailing Address - Country:US
Mailing Address - Phone:208-540-1070
Mailing Address - Fax:
Practice Address - Street 1:449 S MADERA AVE
Practice Address - Street 2:KERMAN HEALTH CENTER VALLEY HEALTH TEAM
Practice Address - City:KERMAN
Practice Address - State:CA
Practice Address - Zip Code:93630-1537
Practice Address - Country:US
Practice Address - Phone:208-540-1070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA116136207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine