Healthcare Provider Details

I. General information

NPI: 1508200312
Provider Name (Legal Business Name): HARI REDDY MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2013
Last Update Date: 04/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 DIXIE CANYON PL
SHERMAN OAKS CA
91423-4841
US

IV. Provider business mailing address

3600 DIXIE CANYON PL
SHERMAN OAKS CA
91423-4841
US

V. Phone/Fax

Practice location:
  • Phone: 951-461-9573
  • Fax:
Mailing address:
  • Phone: 951-461-9573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA98225
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA98225
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA98225
License Number StateCA

VIII. Authorized Official

Name: DR. HARI REDDY
Title or Position: OWNER
Credential: M.D.
Phone: 951-461-9573