Healthcare Provider Details
I. General information
NPI: 1437140332
Provider Name (Legal Business Name): SURENDHER LOKAREDDY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/31/2005
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1945 W 24TH ST
YUMA AZ
85364-6105
US
IV. Provider business mailing address
2400 S AVENUE A
YUMA AZ
85364-7127
US
V. Phone/Fax
- Phone: 928-341-4650
- Fax: 928-341-9779
- Phone: 928-344-2000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 195056 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | MD048704L |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 22345 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: