Provider Demographics
NPI:1952334583
Name:PYREDDY, LOVRDU PRABHAKAR (MD)
Entity Type:Individual
Prefix:DR
First Name:LOVRDU
Middle Name:PRABHAKAR
Last Name:PYREDDY
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 1:6181 N THESTA ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8604
Mailing Address - Country:US
Mailing Address - Phone:559-431-9753
Mailing Address - Fax:559-431-3478
Practice Address - Street 1:6181 N THESTA AVE
Practice Address - Street 2:SUITE # 104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8604
Practice Address - Country:US
Practice Address - Phone:559-431-9753
Practice Address - Fax:559-431-3478
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94932207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A949320Medicaid
CA00A949320Medicaid
CAI54945Medicare UPIN