Basic Information
| Provider Information | |||||||||
| NPI: | 1902020167 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SUREDDI | ||||||||
| FirstName: | RAVI | ||||||||
| MiddleName: | KUMAR | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MBBS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 399 E HIGHLAND AVE | ||||||||
| Address2: | SUITE 424 | ||||||||
| City: | SAN BERNARDINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 924043808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9098835315 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 399 E HIGHLAND AVE | ||||||||
| Address2: | SUITE 424 | ||||||||
| City: | SAN BERNARDINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 924043808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9098835315 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2007 | ||||||||
| LastUpdateDate: | 04/17/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0001X | C56198 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology |
No ID Information.