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General NPI Number Information
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NPI Number | 1104917913
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Entity Type | Individual
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Provider Name | SUREKHA N REDDY M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 08/12/2020
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Provider Practice Location Address
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Address Line | 5959 GREENBACK LN STE 500
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95621-4700
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Country | US
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Telephone | 916-725-1177
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Fax | 916-877-8225
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Provider Business Mailing Address
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Address Line | 777 12TH ST STE 250
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City | SACRAMENTO
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State | CA
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Zip | 95814-1929
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Country | US
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Telephone | 916-550-5487
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A81664
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A81664
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License Number State | CA
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