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General NPI Number Information
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NPI Number | 1942629704
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Entity Type | Individual
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Provider Name | GAYATRI BODDUPALLI MADDURI MD
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Gender | Female
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 04/28/2024
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Provider Practice Location Address
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Address Line | 725 WELCH RD
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City | PALO ALTO
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State | CA
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Zip | 94304-1601
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Country | US
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Telephone | 650-497-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 914 JUDAH ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-2002
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Country | US
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Telephone | 408-314-1478
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A 143321
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 143321
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License Number State | CA
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