Provider Demographics
NPI:1902020167
Name:SUREDDI, RAVI KUMAR (MBBS)
Entity Type:Individual
Prefix:DR
First Name:RAVI
Middle Name:KUMAR
Last Name:SUREDDI
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 MILLIKEN AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-6782
Mailing Address - Country:US
Mailing Address - Phone:909-883-5315
Mailing Address - Fax:
Practice Address - Street 1:1245 WILSHIRE BLVD STE 580
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-4810
Practice Address - Country:US
Practice Address - Phone:213-977-0419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2023-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC56198207RC0001X
PAMD445399207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology