Provider Demographics
NPI:1184911844
Name:MOHAN, SIRISHA RADHIKA (MD)
Entity type:Individual
Prefix:DR
First Name:SIRISHA
Middle Name:RADHIKA
Last Name:MOHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:757 N COLLEGE WAY
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-3944
Mailing Address - Country:US
Mailing Address - Phone:909-621-8222
Mailing Address - Fax:909-621-8472
Practice Address - Street 1:757 N COLLEGE WAY
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-3944
Practice Address - Country:US
Practice Address - Phone:909-621-8222
Practice Address - Fax:909-621-8472
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA137825207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine