Provider Demographics
NPI:1609189737
Name:GOLLAPALLE, ESHA (MD)
Entity Type:Individual
Prefix:
First Name:ESHA
Middle Name:
Last Name:GOLLAPALLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 AMALFI LOOP APT 495
Mailing Address - Street 2:30
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-8086
Mailing Address - Country:US
Mailing Address - Phone:972-571-7840
Mailing Address - Fax:
Practice Address - Street 1:500 AMALFI LOOP APT 495
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-8086
Practice Address - Country:US
Practice Address - Phone:972-571-7840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA128612207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology