Mallareddy Maddula (NPI# 1487762647, PAC ID# 6002807336) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEPHROLOGY.
Nation Provider ID (NPI) | 1487762647 |
PAC ID by PECOS | 6002807336 |
Professional Enrollment ID | I20090825000290 |
Full Name | Mallareddy Maddula |
Organization Legal Name | SAN JOAQUIN KIDNEY CLINIC, INC |
Address |
1801 E March Lane Suite B265 Stockton CA 95210-6629 |
Phone Number | 2095461868 |
Gender | M |
Credential | MD |
Graduation Year | 1997 |
Primary Specialty | NEPHROLOGY |
Secondary Specialties | INTERNAL MEDICINE |
Group Practice PAC ID | 8527009158 |
Number of Group Practice Members | 6 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
050336 | ADVENTIST HEALTH LODI MEMORIAL |
050084 | ST JOSEPHS MEDICAL CENTER OF STOCKTON |
050557 | MEMORIAL MEDICAL CENTER |
050122 | DAMERON HOSPITAL |
050014 | SUTTER AMADOR HOSPITAL |
Address | Phone | Organization |
---|---|---|
1801 E March Lane, Suite B265, Stockton, CA 95210-6629 | 2095461868 | SAN JOAQUIN KIDNEY CLINIC, INC |
Organization Legal Name | SAN JOAQUIN KIDNEY CLINIC, INC |
Physicians | 5 |
Name | Specialty | Organization | Address |
---|---|---|---|
Vishwa Sheth | Internal Medicine | San Joaquin Kidney Clinic, Inc | 1801 E March Ln, Suite B265, Stockton, CA 95210-6655 |
Purushottama B Sagireddy | Nephrology | San Joaquin Kidney Clinic, Inc | 1801 E March Ln, Suite B265, Stockton, CA 95210-6655 |
Ananth N Prakash | Nephrology | San Joaquin Kidney Clinic, Inc | 1801 E March Ln, B265, Stockton, CA 95210-6655 |
Subrahmanyam Nasika | Nephrology | San Joaquin Kidney Clinic, Inc | 1801 E March Lane, Suite B265, Stockton, CA 95210-6629 |
Street Address |
1801 E MARCH LANE SUITE B265 |
City | STOCKTON |
State | CA |
Zip | 95210-6629 |
Name | Specialty | Organization | Address |
---|---|---|---|
Melba Elizaga Agatep Berbano | Obstetrics/gynecology | 1801 E March Lane, Suite C 320, Stockton, CA 95210-6676 | |
Miroslav Djokic | Critical Care (intensivists) | 1801 E March Lane, Suite C300, Stockton, CA 95210-6676 | |
Subrahmanyam Nasika | Nephrology | San Joaquin Kidney Clinic, Inc | 1801 E March Lane, Suite B265, Stockton, CA 95210-6629 |
Harold E Hand | Ophthalmology | Zeiter Eye Medical Group, Inc | 1801 E March Lane, Suite C 350, Stockton, CA 95210-5668 |
Gary A Schenck Jr. | Anesthesiology | 1801 E March Lane, Suite 360, Stockton, CA 95210-6675 | |
Eunah Hwang | Nurse Practitioner | Sanjeev K Goswami Md Inc | 1801 E March Lane, Suite C300, Stockton, CA 95210-6657 |
Name | Specialty | Organization | Address |
---|---|---|---|
Chukwuemeka P Chikwendu | Optometry | 7743 W Ln, A2, Stockton, CA 95210-3350 | |
Kelly A Mcgrane | Optometry | Permanente Medical Group Inc | 1305 Tommydon St, Stockton, CA 95210-3364 |
Sweet V Allen | Internal Medicine | Permanente Medical Group Inc | 1305 Tommydon St, Stockton, CA 95210-3364 |
Yeeyie Eva Fogarty | Radiation Oncology | Permanente Medical Group Inc | 1305 Tommydon St, Stockton, CA 95210-3364 |
Jill D Mackinnon | Physical Medicine and Rehabilitation | Permanente Medical Group Inc | 1305 Tommydon St, Stockton, CA 95210-3364 |
Ashley Y Vande Kieft | Obstetrics/gynecology | Permanente Medical Group Inc | 1305 Tommydon St, Stockton, CA 95210-3364 |
Rama Balaji | Psychiatry | Permanente Medical Group Inc | 1305 Tommydon St, Stockton, CA 95210-3364 |
Ryan T Finlayson | Emergency Medicine | Permanente Medical Group Inc | 1305 Tommydon St, Stockton, CA 95210-3364 |
Lester G Reffigee | Obstetrics/gynecology | Permanente Medical Group Inc | 1305 Tommydon St, Stockton, CA 95210-3364 |
Linda V Packia Raj | Physical Medicine and Rehabilitation | Permanente Medical Group Inc | 1305 Tommydon St, Stockton, CA 95210-3364 |
Find all physicians in zip 95210 |
City | STOCKTON |
Zip Code | 95210 |
Specialty | NEPHROLOGY |
City + Specialty | STOCKTON + NEPHROLOGY |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.