Healthcare Provider Details
I. General information
NPI: 1770435638
Provider Name (Legal Business Name): REDDY MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/12/2026
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4077 5TH AVE
SAN DIEGO CA
92103-2105
US
IV. Provider business mailing address
2108 N ST STE N
SACRAMENTO CA
95816-5712
US
V. Phone/Fax
- Phone: 858-832-2478
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LAYA
REDDY
Title or Position: PHYSICIAN
Credential: MD
Phone: 858-832-2478