Provider Demographics
NPI:1114368149
Name:MAHENDRA, TRIPTI
Entity Type:Individual
Prefix:
First Name:TRIPTI
Middle Name:
Last Name:MAHENDRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 ERIN LN
Mailing Address - Street 2:
Mailing Address - City:HALF MOON BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94019-1776
Mailing Address - Country:US
Mailing Address - Phone:650-274-2665
Mailing Address - Fax:
Practice Address - Street 1:1818 GILBRETH RD
Practice Address - Street 2:SUITE 230
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-1225
Practice Address - Country:US
Practice Address - Phone:650-348-6603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-05
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist