Provider Demographics
NPI:1902890320
Name:REDDY, USHA (MD)
Entity Type:Individual
Prefix:DR
First Name:USHA
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3270 CHURN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-2504
Mailing Address - Country:US
Mailing Address - Phone:530-222-6886
Mailing Address - Fax:530-222-4480
Practice Address - Street 1:199 W SHIELDS AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93705-4102
Practice Address - Country:US
Practice Address - Phone:559-225-4706
Practice Address - Fax:559-225-4710
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA67304207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A673041Medicare ID - Type Unspecified
CAG27721Medicare UPIN