NPIMap

Organization Active NPI

Reda M Tadros MD Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Victorville, CA
National Provider Identifier
1184878167
Registry record updated Nov 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
05D0663016 Issued in CA
Legal business name
REDA M TADROS MD INC
Practice address
15248 11TH St
Victorville, CA 92395-3704
Phone
(760) 843-6262
NPI assigned
Nov 4, 2008
Last updated
Nov 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2008

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

Authorized official

Name
Reda M Tadros, MD
Title
President
Phone
(760) 843-6262

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X 05D0663016 CA Primary

Addresses

Primary practice location

15248 11TH St
Victorville, CA 92395-3704

Mailing address

1633 Erringer Rd
1St Floor
Simi Valley, CA 93065-3583
Phone (805) 578-8300

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225756800000",
    "number": "1184878167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 ERRINGER RD",
            "address_2": "1ST FLOOR",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653583",
            "telephone_number": "805-578-8300",
            "fax_number": "805-578-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15248 11TH ST",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953704",
            "telephone_number": "760-843-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDA M TADROS MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-04",
        "last_updated": "2008-11-04",
        "status": "A",
        "authorized_official_last_name": "TADROS",
        "authorized_official_first_name": "REDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-843-6262",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "05D0663016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.