Provider Demographics
NPI:1578757969
Name:KURUGANTI R. REDDY M.D.
Entity Type:Organization
Organization Name:KURUGANTI R. REDDY M.D.
Other - Org Name:KURUGANTI R. REDDY M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KURUGANTI
Authorized Official - Middle Name:R
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:626-331-8202
Mailing Address - Street 1:530 W BADILLO ST STE B
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-3787
Mailing Address - Country:US
Mailing Address - Phone:626-331-8202
Mailing Address - Fax:626-339-8176
Practice Address - Street 1:530 W BADILLO ST
Practice Address - Street 2:STE B
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722-3787
Practice Address - Country:US
Practice Address - Phone:626-331-8202
Practice Address - Fax:626-339-8176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty