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General NPI Number Information
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NPI Number | 1578757969
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Entity Type | Organization
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Legal Business Name | KURUGANTI R. REDDY M.D.
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 08/29/2007
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Provider Practice Location Address
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Address Line | 530 W BADILLO ST STE B
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City | COVINA
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State | CA
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Zip | 91722-3787
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Country | US
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Telephone | 626-331-8202
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Fax | 626-339-8176
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Provider Business Mailing Address
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Address Line | 530 W BADILLO ST STE B
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City | COVINA
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State | CA
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Zip | 91722-3787
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Country | US
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Telephone | 626-331-8202
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Fax | 626-339-8176
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Authorized Official
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Title or Position | OWNER
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Name | DR. KURUGANTI R REDDY SR.
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Credential | M.D.
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Telephone | 626-331-8202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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