Provider Demographics
NPI:1154675114
Name:KADAMBI, ANIRUDH (MD)
Entity Type:Individual
Prefix:
First Name:ANIRUDH
Middle Name:
Last Name:KADAMBI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6251 MORNING PL
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91737-7763
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1801 ORANGE TREE LN
Practice Address - Street 2:SUITE 200
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-4589
Practice Address - Country:US
Practice Address - Phone:909-557-1600
Practice Address - Fax:909-557-1732
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA143532208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation