Individual provider Active NPI

Vennela Reddy McComb, MD

  • Anesthesiology Physician
  • Porter Ranch, CA
National Provider Identifier
1184078990
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A162760 Issued in CA
Practice address
19740 Falcon Crest Way
Porter Ranch, CA 91326-4029
Phone
(818) 359-0701
NPI assigned
Apr 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A162760 CA Primary

Addresses

Primary practice location

19740 Falcon Crest Way
Porter Ranch, CA 91326-4029

Mailing address

7417 N Cedar Ave
Fresno, CA 93720-3637
Phone (559) 436-0871

Other names 1

  • Vennela Reddy Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190708002579 CA Practitioner - Anesthesiology 8426341314 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A162760CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Springs Anesthesia Services, PC Anesthesiology CurrentSince Dec 23, 2020 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 22, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 22, 2024 Accepting new patients

Locations

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3184

2309 Antonio Ave
Camarillo, CA 93010
Phone (805) 389-5655

1050 Linden Ave
Long Beach, CA 90813
Phone (562) 491-9000

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1184078990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7417 N CEDAR AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203637",
            "telephone_number": "559-436-0871",
            "fax_number": "559-436-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19740 FALCON CREST WAY",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913264029",
            "telephone_number": "818-359-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOMB",
        "first_name": "VENNELA",
        "middle_name": "REDDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-18",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A162760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13652 Cantara St",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914025423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "VENNELA",
            "last_name": "REDDY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Porter Ranch, CA

Sources for this page

Verify at the official NPI Registry.