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General NPI Number Information
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NPI Number | 1194164913
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Entity Type | Organization
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Legal Business Name | INLANDPSYCH REDLANDS INC.
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Dates
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Enumeration Date | 06/14/2013
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Last Update Date | 06/14/2013
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Provider Practice Location Address
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Address Line | 1738 N WATERMAN AVE 2
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-5131
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Country | US
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Telephone | 909-496-1266
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Fax |
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Provider Business Mailing Address
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Address Line | 255 TERRACINA BLVD 204
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City | REDLANDS
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State | CA
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Zip | 92373-4870
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Country | US
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Telephone | 909-496-1266
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEETHA K. PALADUGU
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Credential | M.D.
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Telephone | 909-496-1266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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