Provider Demographics
NPI:1154635506
Name:MADUGUNDI, SHALINI (MD)
Entity Type:Individual
Prefix:
First Name:SHALINI
Middle Name:
Last Name:MADUGUNDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHALINI
Other - Middle Name:
Other - Last Name:DABBADI LAKSHMIPATHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2220 GLADSTONE DR STE 3
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-5123
Mailing Address - Country:US
Mailing Address - Phone:925-432-3318
Mailing Address - Fax:925-432-0886
Practice Address - Street 1:2220 GLADSTONE DR STE 3
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-5123
Practice Address - Country:US
Practice Address - Phone:925-432-3318
Practice Address - Fax:925-432-0886
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA125552207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine