Provider Demographics
NPI:1487658936
Name:REDA, ZACHARIA (MD)
Entity Type:Individual
Prefix:
First Name:ZACHARIA
Middle Name:
Last Name:REDA
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 1:17100 EUCLID ST.
Mailing Address - Street 2:PICU
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708
Mailing Address - Country:US
Mailing Address - Phone:714-966-7253
Mailing Address - Fax:714-966-3354
Practice Address - Street 1:17100 EUCLID ST.
Practice Address - Street 2:PICU
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708
Practice Address - Country:US
Practice Address - Phone:714-966-7253
Practice Address - Fax:714-966-3354
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA479472080P0203X, 2080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine