Reddy, Jagadeeshwar Koripelli

Reddy, Jagadeeshwar Koripelli is an individual health care provider with primary practice located at 374 West Olive Avenue Suite B, Merced CA 95348. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Reddy, Jagadeeshwar Koripelli can be contacted via phone (209) 383-3076.

Contact Information

Primary practice address
374 West Olive Avenue Suite B Merced CA 95348
Fax: (209) 383-6301
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A77851 California
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A77851 California

Profile Details

NPI number 1538199104
LBN Legal business name Reddy, Jagadeeshwar Koripelli
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Dec 11th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538199104 NPPES
California MEDICAID 00A778510

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