Provider Demographics
NPI:1164285573
Name:THOMAS REDA MD INC.
Entity Type:Organization
Organization Name:THOMAS REDA MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:REDA
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:916-633-1494
Mailing Address - Street 1:2217 G ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-3518
Mailing Address - Country:US
Mailing Address - Phone:916-633-1494
Mailing Address - Fax:916-260-2275
Practice Address - Street 1:6620 COYLE AVE STE 214
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-6337
Practice Address - Country:US
Practice Address - Phone:916-572-4720
Practice Address - Fax:916-260-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care