Provider Demographics
NPI:1033415237
Name:VANI VELKURU, MD INC.
Entity Type:Organization
Organization Name:VANI VELKURU, MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VANI
Authorized Official - Middle Name:
Authorized Official - Last Name:VELKURU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-991-7508
Mailing Address - Street 1:1999 MOWRY AVE
Mailing Address - Street 2:SUITE 2 - I
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1738
Mailing Address - Country:US
Mailing Address - Phone:510-991-7508
Mailing Address - Fax:510-991-7503
Practice Address - Street 1:1999 MOWRY AVE
Practice Address - Street 2:SUITE 2 - I
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1738
Practice Address - Country:US
Practice Address - Phone:510-991-7508
Practice Address - Fax:510-991-7503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-04
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96902207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty