Healthcare Provider Details

I. General information

NPI: 1033266721
Provider Name (Legal Business Name): SIREESHA BATTULA D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SIREESHA BATTULA DUGGIRALA DPM

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 10/07/2020
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 EVELYN AVE STE 223
ALBANY CA
94706-1375
US

IV. Provider business mailing address

400 EVELYN AVE STE 223
ALBANY CA
94706-1375
US

V. Phone/Fax

Practice location:
  • Phone: 510-386-8154
  • Fax:
Mailing address:
  • Phone: 510-379-7245
  • Fax: 510-379-5149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE4701
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4701
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: