Organization
REDA TADROS, MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REDA TADROS MD (PRESIDENT)
(760) 245-8691
Entity
Organization
Contact information
Practice address
555 S 7TH AVE, BARSTOW, CA 92311-3043
(805) 578-8300
(805) 578-3911
Mailing address
1633 ERRINGER RD, 1ST FLOOR, SIMI VALLEY, CA 93065-3583
(805) 578-8300
(805) 578-3911
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
Primary
05D0573118
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0573118
CLIA
CA
Enumeration date
01/20/2010
Last updated
01/20/2010
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