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General NPI Number Information
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NPI Number | 1619064979
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Entity Type | Organization
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Legal Business Name | VISTA DEL SOL INTERNAL MEDICINE, PA
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1212 NINTH ST STE C
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City | ALAMOGORDO
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State | NM
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Zip | 88310-5842
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Country | US
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Telephone | 505-434-2965
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Fax | 505-439-8254
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Provider Business Mailing Address
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Address Line | 1212 9TH ST STE C
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City | ALAMOGORDO
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State | NM
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Zip | 88310-5842
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Country | US
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Telephone | 505-434-2965
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Fax | 505-439-8254
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GIRIDHAR ANIREDDY
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Credential | MD
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Telephone | 505-434-2965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | TX
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