Provider Demographics
NPI:1336339555
Name:GADDIPATI, HIMABINDU (MD)
Entity Type:Individual
Prefix:
First Name:HIMABINDU
Middle Name:
Last Name:GADDIPATI
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 1:7930 FROST ST
Mailing Address - Street 2:SUITE #405
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2737
Mailing Address - Country:US
Mailing Address - Phone:858-571-2811
Mailing Address - Fax:858-571-2814
Practice Address - Street 1:7930 FROST ST
Practice Address - Street 2:#405
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123
Practice Address - Country:US
Practice Address - Phone:858-571-2811
Practice Address - Fax:858-571-2814
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA120992207RX0202X
PAMD425058207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)