Provider Demographics
NPI:1275823635
Name:TADI, RAVIKANTH REDDY (MD)
Entity Type:Individual
Prefix:
First Name:RAVIKANTH
Middle Name:REDDY
Last Name:TADI
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 1:12401 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-1006
Mailing Address - Country:US
Mailing Address - Phone:562-698-0811
Mailing Address - Fax:562-789-5902
Practice Address - Street 1:PIH HEALTH WHITTIER HOSPITAL
Practice Address - Street 2:12401 WASHINGTON BLVD
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602
Practice Address - Country:US
Practice Address - Phone:562-698-0811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN15764207R00000X
MO2014022406208M00000X
CA147160207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist