Provider Demographics
NPI:1033146287
Name:DURGA MADALA, M.D., INC.
Entity Type:Organization
Organization Name:DURGA MADALA, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:DURGA
Authorized Official - Middle Name:V
Authorized Official - Last Name:MADALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-356-4242
Mailing Address - Street 1:2516 SAMARITAN DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-4108
Mailing Address - Country:US
Mailing Address - Phone:408-356-4242
Mailing Address - Fax:408-356-4455
Practice Address - Street 1:2516 SAMARITAN DR
Practice Address - Street 2:SUITE A
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4108
Practice Address - Country:US
Practice Address - Phone:408-356-4242
Practice Address - Fax:408-356-4455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty