Healthcare Provider Details

I. General information

NPI: 1942306568
Provider Name (Legal Business Name): VEENA SANKAPPANAVAR GANGASANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VEENA HANAMANTAGOUDA SANKAPPANAVAR M.D.

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2299 MOWRY AVE STE 2A
FREMONT CA
94538-1638
US

IV. Provider business mailing address

2299 MOWRY AVE STE 2A
FREMONT CA
94538-1638
US

V. Phone/Fax

Practice location:
  • Phone: 510-362-7503
  • Fax:
Mailing address:
  • Phone: 510-362-7503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC206082
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number229829
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: