Provider Demographics
NPI:1104026970
Name:GONDI, NEELIMA (MD)
Entity Type:Individual
Prefix:
First Name:NEELIMA
Middle Name:
Last Name:GONDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NEELIMA
Other - Middle Name:
Other - Last Name:YENIGALLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:450 NORTH GREENFIELD AVE
Mailing Address - Street 2:HANFORD MEDICAL ASSOCIATES, INC
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230
Mailing Address - Country:US
Mailing Address - Phone:559-816-3754
Mailing Address - Fax:559-583-4625
Practice Address - Street 1:450 NORTH GREENFIELD AVE
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230
Practice Address - Country:US
Practice Address - Phone:559-816-3754
Practice Address - Fax:559-583-4625
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-14846208M00000X, 207R00000X
CAA109120207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000279117OtherHMSA BILLING NUMBER