Provider Demographics
NPI:1154306991
Name:GUMMARAJU, SRINIVAS C (MD)
Entity Type:Individual
Prefix:DR
First Name:SRINIVAS
Middle Name:C
Last Name:GUMMARAJU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1290 NORTHGATE DR
Mailing Address - Street 2:APT. 53
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-1534
Mailing Address - Country:US
Mailing Address - Phone:530-749-4400
Mailing Address - Fax:
Practice Address - Street 1:4501 X ST
Practice Address - Street 2:SUITE 3016
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2229
Practice Address - Country:US
Practice Address - Phone:530-749-4400
Practice Address - Fax:530-749-4534
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA55763207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology