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Individual

VINAY MOOLA REDDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4420 DUCKHORN DR #200, SACRAMENTO, CA 95834
(916) 419-9900
(916) 419-9699
Mailing address
8825 BELLA TERRA PL, GRANITE BAY, CA 95746-8850
(916) 419-5939

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
00A63460
CA
208VP0000X
Pain Medicine Physician
A63460
CA
208VP0014X
Interventional Pain Medicine Physician
A63460
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20-0221101
CIGNA
CA
01
20-0221101
BLUE SHIELD
01
200221101
TAX ID#
CA
01
P00148938
RAILROAD MEDICARE
CA
Enumeration date
06/14/2006
Last updated
06/11/2019
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