Healthcare Provider Details

I. General information

NPI: 1033140207
Provider Name (Legal Business Name): CHINNAPA REDDY NAREDDY M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 09/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 E HERNDON AVE
FRESNO CA
93720-3309
US

IV. Provider business mailing address

1099 E CHAMPLAIN DR STE - A132
FRESNO CA
93720-5030
US

V. Phone/Fax

Practice location:
  • Phone: 559-434-8133
  • Fax: 559-434-8133
Mailing address:
  • Phone: 559-434-8133
  • Fax: 559-434-8133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA62606
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA62606
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA62606
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: