Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | A262450 | CA |
NPI | 1184722183 |
---|---|
Provider Name | Dr. Mohan P. Reddy |
First Address | Merced, CA 95348-2436 |
Second Address | Merced, CA 95348-2436 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 26/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A262450 | (05) | CA |
A24779 | (02) | CA |