Sudhakar Venkata Mallela MD Inc

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

SUDHAKAR VENKATA MALLELA MD INC

Practice address

6885 Brockton Ave
Riverside, CA 92506-3811

Phone

(702) 256-3637

NPI assigned

Aug 5, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sudhakar Venkata Mallela, MDNPI 1851498729

Title

President

Phone

(702) 256-3637

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sudhakar V Mallela, M.D.

  • Infectious Disease Physician
  • Riverside, CA
  • NPI 1851498729
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531785600000",
    "number": "1518411636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6885 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6885 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063811",
            "telephone_number": "702-256-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUDHAKAR VENKATA MALLELA MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-05",
        "last_updated": "2018-07-17",
        "status": "A",
        "authorized_official_last_name": "MALLELA",
        "authorized_official_first_name": "SUDHAKAR",
        "authorized_official_middle_name": "VENKATA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-256-3637",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jimena Suarez
• Luis Suarez
• Tricia Faeldan Suarez, P.T.A.
• Jeffery Patrick Suchil
• Sudha Moola MD Inc
• Kelly Sudol
• Chase Sugiono
• Yudi Stephen Sugiono, DDS
• Christine Suh, MD
• Elizabeth Suh

• Infectious Disease Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Infectious Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.