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NPI Code Detail

MEDICARE: SANJAY REDDY MD

MEDICARE: SANJAY REDDY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianA90051CA

General Provider Information

NPI Number : 1447206644
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANJAY REDDY MD
Provider Business Mailing Address
First Line : PO BOX 54509
Second Line :
City : LOS ANGELES
State : CA
Zip : 90054-0509
Country : US
Telephone Number : 714-456-8068
Fax Number : 714-456-3765
Provider Business Practice Location Address
First Line : 101 THE CITY DR S
Second Line :
City : ORANGE
State : CA
Zip : 92868-3201
Country : US
Telephone Number : 714-456-8068
Fax Number : 714-456-3765
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2006
Last Update Date : 09/21/2007

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