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Organization
OMNICORE HEALTH SERVICES, INC
Active
Organization
OMNICORE HEALTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MALLU REDDY MD (CEO)
(909) 635-7764
Entity
Organization
Contact information
Practice address
363 S INDIAN HILL BLVD, CLAREMONT, CA 91711-5224
(909) 929-0070
Mailing address
363 S INDIAN HILL BLVD, CLAREMONT, CA 91711-5224
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
106S00000X
Behavior Technician
—
—
167G00000X
Licensed Psychiatric Technician
—
—
207R00000X
Internal Medicine Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
08/30/2023
Last updated
04/10/2024
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