MEDICARE: HANSAA NANDHINNI GOPALAKRISHNAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A200121	CA
2	207Q00000X	Family Medicine Physician	U5411	TX

General Provider Information

NPI Number	:	1033748132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANSAA NANDHINNI GOPALAKRISHNAN MD

Provider Business Mailing Address
First Line	:	6475 CAMDEN AVE STE 105
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95120-2847
Country	:	US
Telephone Number	:	408-997-9155
Fax Number	:

Provider Business Practice Location Address
First Line	:	6475 CAMDEN AVE STE 105
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95120-2847
Country	:	US
Telephone Number	:	408-997-9155
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2020
Last Update Date	:	01/28/2026

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