Healthcare Provider Details

I. General information

NPI: 1477787448
Provider Name (Legal Business Name): PREETHI YETURU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2009
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 MOORPARK AVE SUITE 316
SAN JOSE CA
95128
US

IV. Provider business mailing address

2400 MOORPARK AVE SUITE 316
SAN JOSE CA
95128
US

V. Phone/Fax

Practice location:
  • Phone: 408-885-5000
  • Fax:
Mailing address:
  • Phone: 408-885-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01072007A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number036.133210
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberC184613
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: