Provider Demographics
NPI:1659303980
Name:VEMURI, NIRUPAMA (MD)
Entity Type:Individual
Prefix:
First Name:NIRUPAMA
Middle Name:
Last Name:VEMURI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NIRUPAMA
Other - Middle Name:
Other - Last Name:YALAMANCHILI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:557 W MORTON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-3303
Mailing Address - Country:US
Mailing Address - Phone:559-784-4925
Mailing Address - Fax:559-784-4966
Practice Address - Street 1:557 W MORTON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-3333
Practice Address - Country:US
Practice Address - Phone:559-784-4925
Practice Address - Fax:559-784-4966
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC52775207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C527750Medicaid
CA00C527750OtherBLUE SHIELD PIN
CAZZZ05395ZMedicare PIN
CA00C527750Medicare PIN
CA00C527750Medicaid