Provider Demographics
NPI:1275588055
Name:DONEPUDI, SANDHYA C (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDHYA
Middle Name:C
Last Name:DONEPUDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SANDHYA
Other - Middle Name:C
Other - Last Name:DONEPUDI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD FACC
Mailing Address - Street 1:1701 E CESAR E CHAVEZ AVE
Mailing Address - Street 2:SUITE 125
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-2464
Mailing Address - Country:US
Mailing Address - Phone:323-441-1122
Mailing Address - Fax:323-441-1172
Practice Address - Street 1:2900 LAMB CIR STE 201
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-6344
Practice Address - Country:US
Practice Address - Phone:540-731-2328
Practice Address - Fax:540-639-3950
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039622207RC0000X, 207RI0011X
CAC51005207RC0000X
VA0101274215207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB240857Medicare Oscar/Certification
IN100202990AMedicaid
INF29309Medicare UPIN