Infectious Disease Doctors of Nevada LLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

9640 Issued in NV

Legal business name

INFECTIOUS DISEASE DOCTORS OF NEVADA LLC

Practice address

4445 Magnolia Ave
Riverside, CA 92501-4135

Phone

(951) 788-3000

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Sudhakar V. Mallela, M.D.

Title

President

Phone

(702) 878-3235

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461110400000",
    "number": "1659478527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3022 S DURANGO DR",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891174439",
            "telephone_number": "702-256-3637",
            "fax_number": "702-256-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014135",
            "telephone_number": "951-788-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASE DOCTORS OF NEVADA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-04-20",
        "status": "A",
        "authorized_official_last_name": "MALLELA",
        "authorized_official_first_name": "SUDHAKAR",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-878-3235",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NV",
            "license": "9640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Apr 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.