Provider Demographics
NPI:1215967609
Name:REDIX, LOUIS C JR (MD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:C
Last Name:REDIX
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 819
Mailing Address - Street 2:
Mailing Address - City:BARSTOW
Mailing Address - State:CA
Mailing Address - Zip Code:92312-0819
Mailing Address - Country:US
Mailing Address - Phone:760-242-4808
Mailing Address - Fax:760-242-4889
Practice Address - Street 1:525 MELISSA AVE STE A
Practice Address - Street 2:
Practice Address - City:BARSTOW
Practice Address - State:CA
Practice Address - Zip Code:92311-3002
Practice Address - Country:US
Practice Address - Phone:760-256-0308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG44785207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G447850Medicare ID - Type Unspecified
CAA92528Medicare UPIN