Individual
DR. ABHINAND VENKATA PEDDADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1155 MILL ST, RENO, NV 89502
(775) 982-4000
(775) 982-5639
Mailing address
850 HARVARD WAY, RENO, NV 89502-2055
(775) 982-5262
(775) 982-5496
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
14810
NV
2085R0001X
Radiation Oncology Physician
A47818
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A478180
BLUE SHIELD
CA
05
—
00A478180
—
CA
05
—
1073504791
—
NV
01
—
10966825
CAQH
—
Enumeration date
11/02/2005
Last updated
06/14/2018
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