Individual
MR. PREM REDDY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16850 BEAR VALLEY RD, VICTORVILLE, CA 92395-5794
(760) 241-8000
Mailing address
16850 BEAR VALLEY RD, VICTORVILLE, CA 92395-5794
(760) 241-8000
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A36292
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A362920
—
CA
Enumeration date
05/13/2006
Last updated
07/08/2007
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