Provider Demographics
NPI:1356374029
Name:VANGALA, HEMALATHA (MD)
Entity type:Individual
Prefix:
First Name:HEMALATHA
Middle Name:
Last Name:VANGALA
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 1:1445 VETERANS MEMORIAL CIR
Mailing Address - Street 2:STE B
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-3011
Mailing Address - Country:US
Mailing Address - Phone:530-822-7240
Mailing Address - Fax:530-822-7102
Practice Address - Street 1:1445 VETERANS MEMORIAL CIR
Practice Address - Street 2:STE B
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95993-3011
Practice Address - Country:US
Practice Address - Phone:530-822-7240
Practice Address - Fax:530-822-7102
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78672207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A786720Medicaid
CA00A786723Medicare PIN
CA00A786720Medicaid
CA00A786725Medicare PIN