Healthcare Provider Details

I. General information

NPI: 1225168032
Provider Name (Legal Business Name): REDA MICHAEL TADROS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LAC-USC MEDICAL CENTER 1200 N. STATE STREET ,ROOM 2900
LOS ANGELES CA
90033
US

IV. Provider business mailing address

3152 S BARRINGTON AVE APT G
LOS ANGELES CA
90066-1147
US

V. Phone/Fax

Practice location:
  • Phone: 323-226-7148
  • Fax:
Mailing address:
  • Phone: 310-210-9880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License NumberA84889
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA84889
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: