=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407886799
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BINDUSAGAR H REDDY M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/03/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 579 W PUTNAM AVE
-----------------------------------------------------
City | PORTERVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93257-3260
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-782-8585
-----------------------------------------------------
Fax | 559-782-3297
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 579 W PUTNAM AVE
-----------------------------------------------------
City | PORTERVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93257-3260
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-782-8585
-----------------------------------------------------
Fax | 559-782-3297
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | A48170
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------