Basic Information
Provider Information
NPI: 1114072402
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VALLURUPALLI
FirstName: NEELIMA
MiddleName: G
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: GOGINENI
OtherFirstName: NEELIMA
OtherMiddleName:  
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 1
Mailing Information
Address1: 10470 OLD PLACERVILLE RD
Address2: SUITE 100
City: SACRAMENTO
State: CA
PostalCode: 958272539
CountryCode: US
TelephoneNumber: 8004700071
FaxNumber:  
Practice Location
Address1: 2800 L ST
Address2: 6TH FLOOR
City: SACRAMENTO
State: CA
PostalCode: 958165616
CountryCode: US
TelephoneNumber: 9168874040
FaxNumber: 9168874045
Other Information
ProviderEnumerationDate: 01/24/2007
LastUpdateDate: 07/29/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X224368MAN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RC0000XA108397CAY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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