Healthcare Provider Details

I. General information

NPI: 1922150150
Provider Name (Legal Business Name): TERRENCE P. REDING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 03/08/2021
Certification Date: 03/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2921 SAVIERS RD
OXNARD CA
93033-5314
US

IV. Provider business mailing address

5855 OLIVAS PARK DR
VENTURA CA
93003-7672
US

V. Phone/Fax

Practice location:
  • Phone: 805-487-5588
  • Fax:
Mailing address:
  • Phone: 805-667-2801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License NumberA44625
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: