Provider Demographics
NPI:1942233580
Name:YARLAGADDA, PADMA (MD)
Entity Type:Individual
Prefix:DR
First Name:PADMA
Middle Name:
Last Name:YARLAGADDA
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 1:200 JOSE FIGUERES AVE
Mailing Address - Street 2:SUITE 255
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1500
Mailing Address - Country:US
Mailing Address - Phone:408-223-7474
Mailing Address - Fax:408-223-9339
Practice Address - Street 1:200 JOSE FIGUERES AVE
Practice Address - Street 2:SUITE 255
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1500
Practice Address - Country:US
Practice Address - Phone:408-223-7474
Practice Address - Fax:408-223-9339
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73803207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A738030Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
CAH96626Medicare UPIN