Healthcare Provider Details

I. General information

NPI: 1407806086
Provider Name (Legal Business Name): GEETHA BHUSHAPPAGALA THIPPESWAMY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10430 S DE ANZA BLVD STE 130
CUPERTINO CA
95014-3025
US

IV. Provider business mailing address

10430 S DE ANZA BLVD STE 130
CUPERTINO CA
95014-3025
US

V. Phone/Fax

Practice location:
  • Phone: 408-865-1015
  • Fax:
Mailing address:
  • Phone: 408-865-1015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA85061
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: