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General NPI Number Information
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NPI Number | 1366743197
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Entity Type | Organization
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Legal Business Name | VIJAYA L REDDY MD INC
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Dates
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Enumeration Date | 11/10/2010
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Last Update Date | 11/10/2010
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Provider Practice Location Address
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Address Line | 9261 LAGUNA SPRINGS DR SUITE 100
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City | ELK GROVE
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State | CA
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Zip | 95758-7983
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Country | US
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Telephone | 916-688-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 9261 LAGUNA SPRINGS DR SUITE 100
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City | ELK GROVE
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State | CA
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Zip | 95758-7983
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Country | US
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Telephone | 916-688-1111
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VIJAYA L REDDY MD INC
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Credential | MD
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Telephone | 916-686-7282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A91027
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License Number State | CA
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