NPI Code Detail JSON Logo

1457822157 NPI number — BOMMIREDDY VISHWAS REDDY ND

NPI Number: 1457822157
Health Care Provider/Practitioner: BOMMIREDDY VISHWAS REDDY ND

Information about “1457822157” NPI (BOMMIREDDY VISHWAS REDDY ND) exists in 1457822157 in HTML format HTML  |  1457822157 in plain Text format TXT  |  1457822157 in PDF (Portable Document Format) PDF  |  1457822157 in an XML format XML  formats.

NPI Number : 1457822157 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1457822157",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "REDDY",
    "FirstName": "BOMMIREDDY",
    "MiddleName": "VISHWAS",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "ND",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "REDDY",
    "OtherFirstName": "BOMMI",
    "OtherMiddleName": "VISHWAS",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "ND",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "35190 MARKS RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BARSTOW",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92311-2039",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "760-559-9278",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "35190 MARKS RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BARSTOW",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92311-2039",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "760-559-9278",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/06/2018",
    "LastUpdateDate": "12/06/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "175F00000X",
        "TaxonomyName": "Naturopath",
        "LicenseNumber": "1049",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.