Healthcare Provider Details

I. General information

NPI: 1134858426
Provider Name (Legal Business Name): HIMABINDU CHINNEPALLI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HIMABINDU CHINNEPALLI MD

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11501 DUBLIN BLVD STE 200
DUBLIN CA
94568-2827
US

IV. Provider business mailing address

408 TULIP RESIDENCY CHERLOPALLI
TIRUPATI ANDHRAPRADESH
517505
IN

V. Phone/Fax

Practice location:
  • Phone: 510-284-5400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number0101239696
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: