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NPI Code Detail

MEDICARE: SRIDHAR M REDDY M.D.

MEDICARE: SRIDHAR M REDDY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianR74126AZ
2207RI0011XInterventional Cardiology PhysicianA167870CA

General Provider Information

NPI Number : 1669817987
Entity Type Code : Individual
Provider Name (Legal Business Name) : SRIDHAR M REDDY M.D.
Provider Business Mailing Address
First Line : 13217 HANEY PL
Second Line :
City : LOS ANGELES
State : CA
Zip : 90049-3624
Country : US
Telephone Number : 858-243-0503
Fax Number :
Provider Business Practice Location Address
First Line : 4955 VAN NUYS BLVD STE 308
Second Line :
City : SHERMAN OAKS
State : CA
Zip : 91403-1811
Country : US
Telephone Number : 818-528-1260
Fax Number : 818-528-1261
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2013
Last Update Date : 07/28/2020

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Directions to “ SRIDHAR M REDDY M.D.” Practice Location

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