JAYA REDDY MALLIDI (NPI# 1376786947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376786947 |
| Entity Type | Individual |
| Full Name | JAYA REDDY MALLIDI |
| Credential | MD |
| Practice Address |
500 Doyle Park Dr Ste G05 Santa Rosa CA 95405-4555 |
| Practice Telephone | 7075767100 |
| Practice Fax Number | 7075768482 |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2018-09-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 252857 | MA | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
A134248 | CA | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 252857 | MA | Allopathic & Osteopathic Physicians |
| Street Address |
500 DOYLE PARK DR STE G05 |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95405-4555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230486 | Lizett Camacho | Counselor | 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 | 2020-06-22 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1306246772 | Kirsten Eckert | Advanced Practice Midwife | 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 | 2014-09-03 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1851631642 | Debi M. Emmons | Marriage & Family Therapist | 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 | 2013-02-15 |
| 1841549979 | Karie Louise Klim | Marriage & Family Therapist | 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 | 2012-09-05 |
| 1427314400 | Rachel E. Page | Counselor | 2447 Summerfield Rd., Santa Rosa, CA 95405 | 2012-04-04 |
| 1689991572 | Center for Integral Healing Inc. | Community Health Worker | 182 Farmers Lane, #203, Santa Rosa, CA 95405 | 2010-04-30 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| Find all providers in zip 95405 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811074586 | Sanjay Chamanlal Dhar | Internal Medicine | 4740 Hoen Ave, Santa Rosa, CA 95405-7824 | 2006-11-01 |
| 1770527269 | Jose Veloso Ballesteros | Internal Medicine | 990 Sonoma Ave Ste 2, Santa Rosa, CA 95404-4813 | 2006-06-15 |
| 1205889839 | Norman Panting | Internal Medicine | 3949 Wallace Rd, Santa Rosa, CA 95404-1418 | 2006-05-17 |
| 1053305714 | Ashwani K Bedi | Internal Medicine | 3536 Mendocino Ave Ste 200, Santa Rosa, CA 95403-3634 | 2005-09-08 |
| 1558360479 | Patrick Devlin | Internal Medicine | 1111 Sonoma Ave, Suite 302, Santa Rosa, CA 95405-4819 | 2005-07-21 |
| 1417955287 | Donald Gregory Hopkins | Internal Medicine | 34 Mark West Springs Rd Ste 310, Santa Rosa, CA 95403 | 2005-07-14 |
| 1144764523 | Santa Rosa Vein Associates, Inc | Internal Medicine | 990 Sonoma Ave, Suite 2, Santa Rosa, CA 95404-4813 | 2016-12-05 |
| 1528359296 | Ali Yassen | Internal Medicine | 3536 Mendocino Ave Ste 200, Santa Rosa, CA 95403 | 2011-04-28 |
| 1558599969 | Emily Lai Conway | Internal Medicine | 34 Mark West Springs Rd Fl 3, Santa Rosa, CA 95403 | 2009-06-24 |
| 1144455825 | Vishal Ghanshyam Patel | Internal Medicine | 3536 Mendocino Ave, Ste 200, Santa Rosa, CA 95403-3634 | 2009-05-25 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95405 |
Please comment or provide details below to improve the information on JAYA REDDY MALLIDI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.