Provider Demographics
NPI:1134858426
Name:CHINNEPALLI, HIMABINDU (MD)
Entity type:Individual
Prefix:DR
First Name:HIMABINDU
Middle Name:
Last Name:CHINNEPALLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HIMABINDU
Other - Middle Name:
Other - Last Name:CHINNEPALLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:408 TULIP RESIDENCY
Mailing Address - Street 2:CHERLOPALLI
Mailing Address - City:TIRUPATI
Mailing Address - State:ANDHRAPRADESH
Mailing Address - Zip Code:517505
Mailing Address - Country:IN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11501 DUBLIN BLVD STE 200
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2827
Practice Address - Country:US
Practice Address - Phone:510-284-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-10
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101239696207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2022046533OtherMEDICAL LICENSE
FLTPME4783OtherMEDICAL LICENSE