Provider Demographics
NPI:1225168032
Name:TADROS, REDA MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:REDA
Middle Name:MICHAEL
Last Name:TADROS
Suffix:
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 1:3152 S BARRINGTON AVE APT G
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-1147
Mailing Address - Country:US
Mailing Address - Phone:310-210-9880
Mailing Address - Fax:
Practice Address - Street 1:LAC-USC MEDICAL CENTER
Practice Address - Street 2:1200 N. STATE STREET ,ROOM 2900
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:323-226-7148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84889207ZP0102X, 207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Not Answered207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology