| Kaditam V. Reddy, M.d. | |
|
227 W Janss Rd Ste 350 Thousand Oaks CA 91360-1881 | |
| (805) 918-5008 | |
| (888) 587-3339 |
| Full Name | Kaditam V. Reddy, M.d. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 227 W Janss Rd Ste 350, Thousand Oaks, California |
| Authorized Official Name and Position | Kaditam V Reddy (PRESIDENT) |
| Authorized Official Contact | 8059185008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaditam V. Reddy, M.d. 227 W Janss Rd Ste 350 Thousand Oaks CA 91360-1881 Ph: (805) 918-5008 | Kaditam V. Reddy, M.d. 227 W Janss Rd Ste 350 Thousand Oaks CA 91360-1881 Ph: (805) 918-5008 |
| NPI Number | 1104369552 |
|---|---|
| Provider Enumeration Date | 12/01/2016 |
| Last Update Date | 12/30/2019 |
| Certification Date | 12/30/2019 |
| Medicare PECOS PAC ID | 8820379233 |
|---|---|
| Medicare Enrollment ID | O20161223000094 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104369552 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | A70245 (California) | Primary |
| Provider Name | Kaditam V Reddy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770584245 PECOS PAC ID: 7315922481 Enrollment ID: I20080303000705 |
| Provider Name | Deepa K Reddy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609929397 PECOS PAC ID: 0648287532 Enrollment ID: I20081029000610 |
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