Healthcare Provider Details

I. General information

NPI: 1740253228
Provider Name (Legal Business Name): PRANEETHA REDDY NARAHARI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 E HERNDON AVE STE 210
FRESNO CA
93720-3333
US

IV. Provider business mailing address

1105 E SPRUCE AVE SUITE 201
FRESNO CA
93720-3313
US

V. Phone/Fax

Practice location:
  • Phone: 559-450-7200
  • Fax: 559-450-7214
Mailing address:
  • Phone: 559-450-7200
  • Fax: 559-450-7214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number152162
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA66871
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: