Basic Information
| Provider Information | |||||||||
| NPI: | 1366628604 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VALLI A VUJJENI MD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 242 | ||||||||
| Address2: | |||||||||
| City: | CAMPBELL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950090242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4089601114 | ||||||||
| FaxNumber: | 4089601115 | ||||||||
| Practice Location | |||||||||
| Address1: | 2101 FOREST AVE | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951281448 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4089601114 | ||||||||
| FaxNumber: | 4089601115 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2008 | ||||||||
| LastUpdateDate: | 02/02/2009 | ||||||||
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| AuthorizedOfficialLastName: | VUJJENI | ||||||||
| AuthorizedOfficialFirstName: | VALLI | ||||||||
| AuthorizedOfficialMiddleName: | A. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4089601114 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | A93139 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.