Provider Demographics
NPI:1871734418
Name:REDDY, REKHA BANKULLA (MD)
Entity type:Individual
Prefix:DR
First Name:REKHA
Middle Name:BANKULLA
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:900 MIRAMONTE AVE
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-2457
Mailing Address - Country:US
Mailing Address - Phone:650-965-3323
Mailing Address - Fax:650-965-0706
Practice Address - Street 1:900 MIRAMONTE AVE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-2457
Practice Address - Country:US
Practice Address - Phone:650-965-3323
Practice Address - Fax:650-965-0706
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0054183207Q00000X
HIMD-17979207Q00000X
WAMD60484143207Q00000X
AZ49626207Q00000X
MTMED-PHYS-LIC-34618207Q00000X
CAA87144207Q00000X
ORMD169043207Q00000X
NMMD2014-0743207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine