Provider Demographics
NPI:1154476430
Name:SHAILAJA REDDY, SOMALWAR (MD)
Entity Type:Individual
Prefix:
First Name:SOMALWAR
Middle Name:
Last Name:SHAILAJA REDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHAILAJA
Other - Middle Name:REDDY
Other - Last Name:SOMALWAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1800 HARRISON ST FL 7
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3466
Mailing Address - Country:US
Mailing Address - Phone:510-625-6262
Mailing Address - Fax:510-625-6226
Practice Address - Street 1:7601 STONERIDGE DR
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-4501
Practice Address - Country:US
Practice Address - Phone:925-847-5234
Practice Address - Fax:925-847-5265
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67473207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine