Provider Demographics
NPI:1528272143
Name:NARENDRANATH A REDDY,M.D. INC.
Entity type:Organization
Organization Name:NARENDRANATH A REDDY,M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NARENDRANATH
Authorized Official - Middle Name:A
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-447-8129
Mailing Address - Street 1:301 W HUNTINGTON DR STE 327
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-1501
Mailing Address - Country:US
Mailing Address - Phone:626-447-8129
Mailing Address - Fax:626-447-2094
Practice Address - Street 1:301 W HUNTINGTON DR STE 327
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-1501
Practice Address - Country:US
Practice Address - Phone:626-447-8129
Practice Address - Fax:626-447-2094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31701174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD71767Medicare UPIN
CAA31701Medicare ID - Type Unspecified