Organization
UROLOGY CENTER OF SOUTHERN CALIFORNIA MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MADHUMITHA C REDDY D.O. (CFO)
(951) 677-3000
Entity
Organization
Contact information
Practice address
28078 BAXTER RD, #450, MURRIETA, CA 92563-1402
(951) 677-3000
(951) 672-4171
Mailing address
801 S MAIN ST STE 201, CORONA, CA 92882-3410
(951) 735-2700
(951) 735-7564
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0090700
—
CA
05
—
GR0090703
—
CA
01
—
ZZZ02498Z
BLUE SHIELD
CA
01
—
ZZZ08232Z
BLUE SHIELD
CA
Enumeration date
06/28/2006
Last updated
12/18/2025
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