Healthcare Provider Details

I. General information

NPI: 1033321534
Provider Name (Legal Business Name): VENU REDDY MD & VJ REDDY MD LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 06/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST STE 1160
HONOLULU HI
96826-1089
US

IV. Provider business mailing address

1319 PUNAHOU ST STE 1160
HONOLULU HI
96826-1089
US

V. Phone/Fax

Practice location:
  • Phone: 808-942-7707
  • Fax: 800-955-3301
Mailing address:
  • Phone: 808-942-7707
  • Fax: 800-955-3301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number2016
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number12445
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number1763
License Number StateHI

VIII. Authorized Official

Name: MRS. ALARICE KIM
Title or Position: OFFICE MANAGER
Credential:
Phone: 808-942-7707