Mallu Reddy MD Inc

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

MALLU REDDY MD INC

Doing business as

Reddy Care Medical

Practice address

1196 N Park Ave
Pomona, CA 91768-3027

Phone

(909) 623-4050

Fax

(909) 620-5259

NPI assigned

Aug 16, 2010

Last updated

Aug 21, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mallu Chenna Reddy, M.D.NPI 1942278221

Title

Ceo/Director

Phone

(909) 623-4050

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Reddy Care Medical Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Mallu Reddy, M.D. Inc.

  • Internal Medicine Physician
  • Pomona, CA
  • NPI 1184821340

  O20080317000645

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

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.

• Mallu C Reddy, MD

  • Internal Medicine Physician
  • Pomona, CA
  • NPI 1942278221
  NPD Authorized official
• Christian Custodio, FNP

  • Primary Care Nurse Practitioner
  • Pomona, CA
  • NPI 1811502404
  NPD
• Jose De Jesus Macias-Zacarias, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Pomona, CA
  • NPI 1336910744
  NPD
• Marvin Gil Manalo

  • Family Nurse Practitioner
  • Panorama City, CA
  • NPI 1437971561
  NPD
• Jane N Perez, FNP

  • Family Nurse Practitioner
  • Pomona, CA
  • NPI 1679322184

  Multi-Specialty

  NPD
• Barbara Arganda Roces, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Irwindale, CA
  • NPI 1043462252
  NPD
• Erica Natalie Michelle Rodriguez, FNP-C

  • Family Nurse Practitioner
  • Pomona, CA
  • NPI 1194449439
  NPD

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1902111834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1196 N PARK AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917683027",
            "telephone_number": "909-623-4050",
            "fax_number": "909-620-5259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1196 N PARK AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917683027",
            "telephone_number": "909-623-4050",
            "fax_number": "909-620-5259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALLU REDDY MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-16",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "MALLU",
        "authorized_official_middle_name": "CHENNA",
        "authorized_official_title_or_position": "CEO/DIRECTOR",
        "authorized_official_telephone_number": "909-623-4050",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A629580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reddy Care Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Reddy Care Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Greg Ellis Maler, DO
• Krishan Malhotra, M.D.
• Maria Maligo
• Maya Malik
• Zachary Mallender
• Mallu Reddy, M.D. Inc.
• Sarita Mallya, MD
• Amanda K Malone
• Jordyn Malone
• Tyler Malone

• Urgent Care Clinic/Center in Pomona, CA
• Providers in Pomona, CA by specialty
• Urgent Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.