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Organization
SPINE & NERVE DIAGNOSTIC CENTER
Active
Organization
SPINE & NERVE DIAGNOSTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINAY MOOLA REDDY MD (PRESIDENT AND CEO)
(916) 772-5325
Entity
Organization
Contact information
Practice address
985 SUN CITY LN STE 111, LINCOLN, CA 95648-7519
(916) 772-5325
Mailing address
4200 DOUGLAS BLVD, GRANITE BAY, CA 95746-5902
(916) 772-5325
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
11/13/2025
Last updated
11/13/2025
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