Provider Demographics
NPI:1508945270
Name:SUNANDA REDDY VADAPALLI, MD, INC
Entity Type:Organization
Organization Name:SUNANDA REDDY VADAPALLI, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUNANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:VADAPALLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-253-4971
Mailing Address - Street 1:24515 KANSAS ST
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-1719
Mailing Address - Country:US
Mailing Address - Phone:661-253-4971
Mailing Address - Fax:661-253-4972
Practice Address - Street 1:24515 KANSAS ST
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-1719
Practice Address - Country:US
Practice Address - Phone:661-253-4971
Practice Address - Fax:661-253-4972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG80948208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty