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General NPI Number Information
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NPI Number | 1669146015
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Entity Type | Organization
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Legal Business Name | T SQRD MEDICAL GROUP, P.A.
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Dates
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Enumeration Date | 08/08/2021
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Last Update Date | 08/08/2021
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Provider Practice Location Address
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Address Line | 16755 LITTLEFIELD LN
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City | LOS GATOS
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State | CA
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Zip | 95032-5601
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Country | US
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Telephone | 408-357-4751
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Fax |
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Provider Business Mailing Address
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Address Line | 16755 LITTLEFIELD LN
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City | LOS GATOS
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State | CA
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Zip | 95032-5601
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Country | US
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Telephone | 408-357-4751
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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. MOHAN MALLIPEDDI
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Credential | MD
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Telephone | 408-823-6970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #6
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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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Taxonomy #7
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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