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General NPI Number Information
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NPI Number | 1124014923
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Entity Type | Individual
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Provider Name | ANANTHRAM POTTIPATI REDDY M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 6699 ALVARADO RD STE 2301
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City | SAN DIEGO
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State | CA
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Zip | 92120-5241
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Country | US
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Telephone | 619-588-4074
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Fax | 619-588-4004
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Provider Business Mailing Address
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Address Line | 9456 CUYAMACA ST SUITE 102
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City | SANTEE
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State | CA
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Zip | 92071-5915
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Country | US
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Telephone | 619-588-4074
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Fax | 619-588-4004
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 35064253
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 17118
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD044783L
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | C 52423
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License Number State | CA
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