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General NPI Number Information
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NPI Number | 1871551242
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Entity Type | Organization
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Legal Business Name | VEENA H KUPPALLI
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 02/07/2011
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Provider Practice Location Address
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Address Line | 14414 LIDDICOAT CIR
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City | LOS ALTOS
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State | CA
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Zip | 94022-1851
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Country | US
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Telephone | 209-575-4575
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Fax | 209-575-4598
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Provider Business Mailing Address
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Address Line | PO BOX 4978
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City | MODESTO
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State | CA
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Zip | 95352-4978
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Country | US
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Telephone | 209-575-4575
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Fax | 209-575-4598
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JUNE ADAMS
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Credential |
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Telephone | 209-575-4575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246QH0600X
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Taxonomy Name | Histology Specialist/Technologist
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License Number |
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License Number State |
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