Provider Demographics
NPI:1447326533
Name:BENDAOUD, REDA (MD)
Entity type:Individual
Prefix:DR
First Name:REDA
Middle Name:
Last Name:BENDAOUD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 S MYRTLE AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-3427
Mailing Address - Country:US
Mailing Address - Phone:626-357-3258
Mailing Address - Fax:626-301-0868
Practice Address - Street 1:902 S MYRTLE AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-3427
Practice Address - Country:US
Practice Address - Phone:626-357-3258
Practice Address - Fax:626-301-0868
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA825082084N0400X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology