MR. PREM REDDY (NPI# 1639120736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639120736 |
| Entity Type | Individual |
| Full Name | MR. PREM REDDY |
| Credential | M.D. |
| Practice Address |
16850 Bear Valley Rd Victorville CA 92395-5794 |
| Practice Telephone | 7602418000 |
| Mailing Telephone | 7602418000 |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
A36292 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A362920 | 05 |
| Street Address |
16850 BEAR VALLEY RD |
| City | VICTORVILLE |
| State | CA |
| Zip Code | 92395-5794 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932104908 | Renaissance Radiology Medical Group, Inc. | Radiology | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2005-06-16 |
| 1780216853 | Hieu Trung Huynh | Pharmacist | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2020-02-06 |
| 1801428107 | Stephanie Victoria Ingrassia | Nurse Practitioner | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2020-02-05 |
| 1831737188 | Jannet Cardin | Pharmacist | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2019-12-18 |
| 1265070684 | Regina Renee Cendejas | Nurse Practitioner | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2019-12-16 |
| 1013568526 | Krystle Ann Frazier | Nurse Practitioner | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2019-09-25 |
| 1265088116 | Stephany Salazar | Clinic/Center | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2019-08-16 |
| 1346893054 | Junel Buenafe Tagayuna | Pharmacist | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2019-07-22 |
| 1942865381 | Duvan Martinez | Nurse Practitioner | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2019-05-01 |
| 1568925378 | Nicole Marie Sweeney | Speech-Language Pathologist | 16850 Bear Valley Rd, Victorville, CA 92395-5795 | 2019-04-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837966 | Desert Ridge Transitional Care Center, Lp | Skilled Nursing Facility | 13300 11th Avenue, Victorville, CA 92395 | 2020-06-26 |
| 1376179093 | Catherine Ward | Speech-Language Pathologist | 13275 Mauka Ct, Victorville, CA 92395 | 2020-03-13 |
| 1174019228 | Laura Mercado Halterman | Family Medicine | 16519 Victor St Ste 307, Victorville, CA 92395 | 2018-07-02 |
| 1306337829 | Stephanie Ann Kruger | Behavior Technician | Sunny Days Inc 3602 Inland Empire Blvd., Ontario, CA 92395 | 2018-05-21 |
| 1861903924 | Debra L Andersen | Clinic/Center | 12830 Hesperia Road, Suite C, D, E, Victorville, CALIFORNIA 92395 | 2017-10-17 |
| 1790202141 | Joshua Powers | Physician Assistant | 12550 Hesperia Rd Ste 101, Victorville, CA 92395 | 2017-08-26 |
| 1043759491 | Kemp Individual & Family Therapy, Inc. | Marriage & Family Therapist | 14075 Hesperia Road, Suite 101, Victorville, CA 92395 | 2017-02-17 |
| 1740725969 | Abem Transportation Inc | Non-emergency Medical Transport (VAN) | 15000 7th St Ste F208, Victorville, CA 92395 | 2016-12-23 |
| 1447669379 | Tracie Girard | Nurse Practitioner | 17330 Bear Valley Road, Suite A106, Victorville, CA 92395 | 2014-08-05 |
| 1093153215 | Mitesh Patel | Surgery | 13010 Hesperia Rd Ste 400, Victorville, CA 92395 | 2013-06-10 |
| Find all providers in zip 92395 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093044794 | Lesan Banko, M.d. Inc. | Internal Medicine | 12984 Hesperia Rd Ste 100, Victorville, CA 92395-5819 | 2009-12-09 |
| 1861648560 | Lesanemariam Tenkir Banko | Internal Medicine | 12984 Hesperia Rd, Ste 100, Victorville, CA 92395-5819 | 2008-08-13 |
| 1962429431 | Omer Ahmed | Internal Medicine | 15201 11th St Ste 400, Victorville, CA 92395-3735 | 2006-07-17 |
| 1992347298 | Michelle Lee Hastings | Internal Medicine | 13024 Hesperia Rd Ste 103, Victorville, CA 92395-8303 | 2019-10-08 |
| 1922460047 | Chirag P. Mehta, Md Inc. | Internal Medicine | 13010 Hesperia Rd, Suite 500, Victorville, CA 92395-5837 | 2016-03-28 |
| 1033577044 | High Desert Heart Vascular Institute, A California Professional Corp | Internal Medicine | 12780 Hesperia Rd, Victorville, CA 92395-5806 | 2016-02-04 |
| 1134319890 | Morakod Lim | Internal Medicine | 16850 Bear Valley Rd, Suite 105, Victorville, CA 92395-5794 | 2007-07-30 |
| 1346440500 | Ahmed Medical Corporation | Internal Medicine | 15201 11th St Ste 400, Victorville, CA 92395-3735 | 2007-07-24 |
| 1710068366 | Mohammad Aslam | Internal Medicine | 16850 Bear Valley Rd, Suite 105, Victorville, CA 92395 | 2006-10-18 |
| 1609806041 | Siva Arunasalam | Internal Medicine | 12780 Hesperia Rd, Victorville, CA 92395-5806 | 2006-07-03 |
| Find all providers in VICTORVILLE | ||||
| City | VICTORVILLE |
| Zip Code | 92395 |
Please comment or provide details below to improve the information on MR. PREM REDDY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.