Provider Demographics
NPI:1740747427
Name:SRILAKSHMI VEMULAKONDA, MD INC
Entity Type:Organization
Organization Name:SRILAKSHMI VEMULAKONDA, MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SRILAKSHMI
Authorized Official - Middle Name:
Authorized Official - Last Name:VEMULAKONDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-599-9080
Mailing Address - Street 1:20660 STEVENS CREEK BLVD # 389
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-2120
Mailing Address - Country:US
Mailing Address - Phone:408-599-9080
Mailing Address - Fax:408-993-1521
Practice Address - Street 1:225 N JACKSON AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1603
Practice Address - Country:US
Practice Address - Phone:408-993-1500
Practice Address - Fax:408-993-1521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-28
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty