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General NPI Number Information
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NPI Number | 1073614301
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Entity Type | Individual
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Provider Name | SUKSHMA REDDY SREEPATHI M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 200 UCLA MEDICAL PLZ STE 265
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City | LOS ANGELES
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State | CA
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Zip | 90095-4542
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Country | US
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Telephone | 310-825-0867
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Fax | 310-794-5066
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Provider Business Mailing Address
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Address Line | 5767 W CENTURY BLVD STE 400
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City | LOS ANGELES
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State | CA
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Zip | 90045-5631
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | C41958
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License Number State | CA
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