MEDICARE: DR. NAVEEN 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
1	207P00000X	Emergency Medicine Physician	A75877	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770511602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAVEEN REDDY M.D.

Provider Business Mailing Address
First Line	:	4521 E. CESAR CHAVEZ AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-1116
Country	:	US
Telephone Number	:	310-892-4232
Fax Number	:

Provider Business Practice Location Address
First Line	:	4521 E. CESAR CHAVEZ AVE.
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-1116
Country	:	US
Telephone Number	:	323-269-4509
Fax Number	:	323-269-4509

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	04/09/2024

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