Provider Demographics
NPI:1184910390
Name:KATTADY, GISHA (MD)
Entity type:Individual
Prefix:DR
First Name:GISHA
Middle Name:
Last Name:KATTADY
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 1:1450 TREAT BLVD # 300
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-2168
Mailing Address - Country:US
Mailing Address - Phone:925-952-2828
Mailing Address - Fax:925-952-2850
Practice Address - Street 1:3466 MT. DIABLO BLVD
Practice Address - Street 2:#C104
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596
Practice Address - Country:US
Practice Address - Phone:925-296-7490
Practice Address - Fax:925-283-8687
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301098526207R00000X
CAA129457207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine