Provider Demographics
NPI:1831379189
Name:DRS LALITHA AND RAVI REDDY
Entity type:Organization
Organization Name:DRS LALITHA AND RAVI REDDY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVINDRANATH
Authorized Official - Middle Name:ARANI
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-784-9579
Mailing Address - Street 1:591 W PUTNAM AVE
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-3260
Mailing Address - Country:US
Mailing Address - Phone:559-784-9579
Mailing Address - Fax:559-784-2443
Practice Address - Street 1:591 W PUTNAM AVE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-3260
Practice Address - Country:US
Practice Address - Phone:559-784-9579
Practice Address - Fax:559-784-2443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-04
Last Update Date:2007-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA234259261QP2300X
CAA34260261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA27432Medicare UPIN
CAA27431Medicare UPIN