Provider Demographics
NPI:1699069146
Name:IYENGAR, SREESH GOPAL (MD)
Entity type:Individual
Prefix:DR
First Name:SREESH
Middle Name:GOPAL
Last Name:IYENGAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3660 PARK SIERRA DR STE 203
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3071
Mailing Address - Country:US
Mailing Address - Phone:951-687-3400
Mailing Address - Fax:951-687-7630
Practice Address - Street 1:401 E HIGHLAND AVE STE 551
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-3840
Practice Address - Country:US
Practice Address - Phone:909-882-9150
Practice Address - Fax:951-883-8972
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2021-08-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA128686207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology