Healthcare Provider Details

I. General information

NPI: 1104026970
Provider Name (Legal Business Name): NEELIMA GONDI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NEELIMA YENIGALLA

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 03/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 NORTH GREENFIELD AVE
HANFORD CA
93230
US

IV. Provider business mailing address

450 NORTH GREENFIELD AVE HANFORD MEDICAL ASSOCIATES, INC
HANFORD CA
93230
US

V. Phone/Fax

Practice location:
  • Phone: 559-816-3754
  • Fax: 559-583-4625
Mailing address:
  • Phone: 559-816-3754
  • Fax: 559-583-4625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD-14846
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD-14846
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA109120
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA109120
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: